BackgroundObesity is associated with functional impairment, institutionalization, and increased mortality risk in elders. Dynapenia is defined as reduced muscle strength and is a known independent predictor of adverse events and disability. The synergy between dynapenia and obesity leads to worse outcomes than either independently. We identified the impact of dynapenic obesity in a cohort at risk for and with knee osteoarthritis on function.MethodsWe identified adults aged ≥ 60 years from the Osteoarthritis Initiative. Obesity was defined as a body mass index ≥ 30 kg/m2. Dynapenia was classified using the lowest sex-specific tertile of knee extensor strength. Participants were grouped according to obesity and knee strength: dynapenic obesity; dynapenia without obesity; obesity without dynapenia; and no dynapenia nor obesity. Four-year data was available. Self-reported activities of daily living (ADL) were assessed at follow-up. Outcomes of gait speed, 400 m walk distance, Late-life Disability and Function Index (LLFDI), and Short-Form (SF)-12 were analyzed using mixed effects and logistic regression models.ResultsOf 2025 subjects (56.3 % female), mean age was 68.2 years and 182 (24.1 %) had dynapenic obesity. Dynapenic obesity was associated with reduced gait speed, LLFDI-limitations, and SF-12 physical score in both sexes and in the 400 m walk in men only (all p < 0.001). A time*group interaction was significant for dynapenic obese men in the 400 m walk distance only. Odds of ADL limitations in dynapenic obesity was OR 2.23 [1.42:3.50], in dynapenia 0.98 [0.66:1.46], and in obesity 1.98 [1.39:2.80] in males. In females, odds were 2.45 [1.63:3.68], 1.60 [1.15:2.22], and 1.47 [1.06:2.04] respectively.ConclusionDynapenic obesity may be a risk factor for functional decline suggesting the need to target subjects with low knee strength and obesity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0118-9) contains supplementary material, which is available to authorized users.

Our review suggests that anticoagulation therapy for calf vein DVT may decrease the incidence of PE and thrombus propagation. However, due to poor methodologic quality and few events among included studies for PE, this finding is not robust. Thrombus propagation appears reduced with anticoagulation treatment. A rigorous RCT will assist in treatment decisions for calf vein DVT.