Body mass index, waist circumference and pre-frailty/frailty: the Tromsø study 1994−2016

Uchai, Shreeshti; Andersen, Lene Frost; Hopstock, Laila Arnesdatter; Hjartåker, Anette

doi:10.1136/bmjopen-2022-065707

Cited by 13 publications

(3 citation statements)

References 53 publications

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“…Frailty is a multifactorial syndrome influenced by demographic and disease‐specific factors [1]. Results from our study mirror those seen in other populations [22–24]. Specifically, frail patients were more likely to be older, female, obese and belong to a lower income quartile.…”

Section: Discussionsupporting

confidence: 80%

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

Sharma,

McKechnie,

Heimann

et al. 2024

Colorectal Disease

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AimPreoperative frailty has been associated with adverse postoperative outcomes in various populations, but of its use in patients with inflammatory bowel disease (IBD) remains sparse. The present study aimed to characterize the impact of frailty, as measured by the modified frailty index (mFI), on postoperative clinical and resource utilization outcomes in patients with IBD.MethodsThis retrospective population‐based cohort study assessed patients from the National Inpatient Sample database from 1 September 2015 to 31 December 2019. Corresponding International Classification of Diseases 10th Revision Clinical Modification codes were used to identify adult patients (>18 years of age) with IBD, undergoing either small bowel resection, colectomy or proctectomy. Patient demographics and institutional data were collected for each patient to calculate the 11‐point mFI. Patients were categorized as either frail or robust using a cut‐off of 0.27. Primary outcomes were postoperative in‐hospital morbidity and mortality, whilst secondary outcomes included system‐specific morbidity, length of stay, in‐hospital healthcare costs and discharge disposition. Logistic and linear regression models were used for primary and secondary outcomes.ResultsOverall, 7144 patients with IBD undergoing small bowel resection, colectomy or proctectomy were identified, 337 of whom were classified as frail (i.e., mFI < 0.27). Frail patients were more likely to be women, older, have lower income and a greater number of comorbidities. After adjusting for relevant covariates, frail patients were at greater odds of in‐hospital mortality (adjusted odds ratio [aOR] 5.42, 95% CI 2.31–12.77, P < 0.001), overall morbidity (aOR 1.72, 95% CI 1.30–2.28, P < 0.001), increased length of stay (adjusted mean difference 1.3 days, 95% CI 0.09–2.50, P = 0.035) and less likely to be discharged to home (aOR 0.59, 95% CI 0.45–0.77, P < 0.001) compared to their robust counterparts.ConclusionsFrail IBD patients are at greater risk of postoperative mortality and morbidity, and reduced likelihood of discharge to home, following surgery. This has implications for clinicians designing care pathways for IBD patients following surgery.

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Section: Discussionsupporting

confidence: 80%

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

Sharma,

McKechnie,

Heimann

et al. 2024

Colorectal Disease

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“…Growing evidence, including our previous research [8,9], suggests that high adiposity, assessed by anthropometric measures such as body mass index (BMI) and waist circumference (WC) [10][11][12][13][14], as well as dualenergy X-ray absorptiometry (DXA)-derived measures such as fat mass index (FMI) and visceral adipose tissue (VAT) mass [14][15][16][17][18][19], is an important risk factor for pre-frailty and frailty. Given the rising obesity epidemic across all age groups [20], this is of major concern.…”

Section: Introductionmentioning

confidence: 99%

Does the association between adiposity measures and pre-frailty among older adults vary by social position? Findings from the Tromsø study 2015/2016

Uchai,

Andersen,

Thoresen

et al. 2024

BMC Public Health

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Introduction Pre-frailty provides an ideal opportunity to prevent physical frailty and promote healthy ageing. Excess adiposity has been associated with an increased risk of pre-frailty, but limited studies have explored whether the association between adiposity measures and pre-frailty varies by social position. Methods We used data from the seventh survey of the Tromsø Study (Tromsø7) conducted in 2015–2016. Our primary sample consisted of 2,945 women and 2,794 men aged ≥ 65 years. Pre-frailty was defined as the presence of one or two of the five frailty components: low grip strength, slow walking speed, exhaustion, unintentional weight loss and low physical activity. Adiposity was defined by body mass index (BMI), waist circumference (WC), fat mass index (FMI) and visceral adipose tissue (VAT) mass. Education and subjective social position were used as measures of social position. Poisson regression with robust variance was used to assess the association between adiposity measures and pre-frailty, and the interaction term between adiposity measures and social position measures were utilised to explore whether the association varied by social position. Results In our sample, 28.7% of women and 25.5% of men were pre-frail. We found sub-multiplicative interaction of BMI-defined obesity with education in women and subjective social position in men with respect to development of pre-frailty. No other adiposity measures showed significant variation by education or subjective social position. Regardless of the levels of education or subjective social position, participants with excess adiposity (high BMI, high WC, high FMI and high VAT mass) had a higher risk of pre-frailty compared to those with low adiposity. Conclusion We consistently observed that women and men with excess adiposity had a greater risk of pre-frailty than those with low adiposity, with only slight variation by social position. These results emphasize the importance of preventing excess adiposity to promote healthy ageing and prevent frailty among all older adults across social strata.

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“…The main factors that can modulate physical fitness in frailty are physical activity and inactivity, being of high interest regarding their analysis as protective or risk factors for frailty [ 9 , 10 ]. Thus, whereas physical activity has been proposed as a fundamental strategy to prevent the appearance of frailty [ 11 ], it is still less clear how bouted physical activity is related to frailty.…”

Section: Introductionmentioning

confidence: 99%

Risk and Protective Factors for Frailty in Pre-Frail and Frail Older Adults

Corral-Pérez

Ávila-Cabeza-de-Vaca

González-Mariscal

et al. 2023

IJERPH

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This study aims to evaluate the differences in body composition, physical function, and physical activity between pre-frail/frail older adults and to detect risk and protective factors against frailty and physical frailty. Fried’s criteria for frailty and physical frailty using the short-performance physical battery (SPPB) were measured in 179 older participants (75.3 ± 6.4 years old). Body weight, height, and waist, arm, and leg circumferences were obtained as body composition variables. Daily accelerometer outcomes (physical activity and inactivity) were obtained. Pre-frail participants showed overall better physical function and spent more time in physical activity and less time in long inactivity periods than frail participants (p < 0.05). Risk frailty factors were higher waist perimeter (Odds Ratio [OR]: 1.032, 95%CI: 1.003–1.062), low leg performance (OR: 1.025, 95%CI: 1.008–1.043), and inactivity periods longer than 30 min (OR:1.002, 95%CI: 1.000–1.005). Protective factors were standing balance (OR:0.908, 95%CI: 0.831–0.992) and SPPB score (OR: 0.908, 95%CI: 0.831–0.992) for frailty, handgrip strength (OR: 0.902, 95%CI: 0.844–0.964) for physical frailty, and light (OR: 0.986, 95%CI: 0.976–0.996) and moderate-to-vigorous (OR: 0.983, 95%CI: 0.972–0.996) physical activity for both. Our findings suggest that handgrip strength, balance, and physical activity are protective frailty factors and can be monitored in pre-frail older adults. Moreover, poor lower body performance and long inactivity periods are frailty risk factors, which highlights their importance in frailty assessment.

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Body mass index, waist circumference and pre-frailty/frailty: the Tromsø study 1994−2016

Cited by 13 publications

References 53 publications

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

Frailty in inflammatory bowel disease: analysis of the National Inpatient Sample 2015–2019

Does the association between adiposity measures and pre-frailty among older adults vary by social position? Findings from the Tromsø study 2015/2016

Risk and Protective Factors for Frailty in Pre-Frail and Frail Older Adults

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