Mediating effect of waist:height ratio on the association between BMI and frailty: the Korean Frailty and Aging Cohort Study

Kim, Minseo; Lee, Yunhwan; Kim, Eun Young; Park, Yongsoon

doi:10.1017/s0007114519002058

Cited by 10 publications

(11 citation statements)

References 42 publications

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“…Our findings are similar to those from previous cross-sectional [6,[11][12][13][14][15][16] and longitudinal [18][19][20][21][22][23][24][25] studies that demonstrated a U-or J-shaped relationship between BMI and frailty. Gajic-Veljanoski et al [41], using the Canadian Multi-Centre Osteoporosis Study, found that baseline BMIs �25 kg/m 2 was associated with faster frailty progression over 5-years with the greatest effect among those with BMI �40 kg/m 2 when compared to those with normal weight.…”

Section: Discussionsupporting

confidence: 91%

“…Longitudinal studies have also found that obesity predicts the development of frailty [18][19][20][21][22][23][24][25]. For example, a study by Stenholm et al [24] concluded that midlife obesity led to a fivefold increase in the risk of frailty over a 22-year follow up compared to those of normal weight among participants in the Mini-Finland Health Examination Survey.…”

Section: Introductionmentioning

confidence: 99%

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Body mass index and physical frailty among older Mexican Americans: Findings from an 18-year follow up

Rutherford

Downer

et al. 2022

PLoS ONE

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Purposes The relationship between body mass index (BMI) and frailty in older Mexican Americans has not been previously studied. The objective of this study was to examine the relationship between BMI and frailty among non-frail older Mexican Americans at baseline over 18 years of follow up. Methods Longitudinal population-based study of 1,648 non-institutionalized Mexican Americans aged ≥ 67 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13). Frailty phenotype was defined as meeting three or more of the following: unintentional weight loss of >10 pounds, weakness, self-reported exhaustion, low physical activity, and slow walking speed. BMI (kg/m2) was classified as underweight (<18.5), normal weight (18.5-<25), overweight (25-< 30), obesity category I (30-<35), and obesity category II/morbid obesity (≥35). Covariates included socio-demographics, comorbidities, cognitive function, and depressive symptoms. Generalized Estimating Equation models were performed to estimate the odds ratio (OR) and 95% confidence interval (CI) of frailty as a function of BMI category. Results Participants with underweight or obesity category II/ morbid obesity had greater odds of frailty over time compared to those with normal weight (OR = 2.39, 95% CI = 1.29–4.44 and OR = 1.62, 95% CI = 1.07–2.44, respectively) after controlling for all covariates. Participants with BMIs in the overweight or category I obesity were at lower odds of frailty over time. Conclusions Mexican American older adults with BMIs in the underweight or obesity category II/morbid obesity were at higher odds of frailty over time. This indicates that maintaining a healthy weight in this population may prevent future frailty.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Body mass index and physical frailty among older Mexican Americans: Findings from an 18-year follow up

Rutherford

Downer

et al. 2022

PLoS ONE

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“…Our study showed that malnutrition was associated with a substantially increased prevalence of frailty in the total sample and in both gender groups. The relation between malnutrition and frailty was already clearly established in previous studies, and overweight and obesity often co-exist with frailty [ 21 , 22 , 27 , 28 , 63 , 64 , 65 ].…”

Section: Discussionmentioning

confidence: 85%

“…Similar results were found in the Japanese cohort with a lowest incidence of frailty at a BMI between 21.4 and 25.7 kg/m 2 [ 22 ]. As shown by Kim et al, the risk of frailty is higher in obese women, which is mediated by WHTR, but not in obese men [ 28 ]. In Spain, two cohort studies showed a parallel change of abdominal obesity and BMI to be associated with an increasing risk of frailty [ 63 ].…”

Section: Discussionmentioning

confidence: 99%

“…BMI was also associated with frailty in a U shape trend, with both low and high BMI being associated with higher incidence of frailty [ 21 , 22 , 23 , 24 , 25 ]. Furthermore, central obesity characterized by a high waist circumference (WC), has also been linked to frailty risk, and recent studies even reported that the association between BMI and frailty was in part mediated by waist to height ratio (WHTR) [ 26 , 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Dietary Patterns and Risk Factors of Frailty in Lebanese Older Adults

Yaghi

Abifadel

et al. 2021

Nutrients

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Factors associated with frailty, particularly dietary patterns, are not fully understood in Mediterranean countries. This study aimed to investigate the association of data-driven dietary patterns with frailty prevalence in older Lebanese adults. We conducted a cross-sectional national study that included 352 participants above 60 years of age. Sociodemographic and health-related data were collected. Food frequency questionnaires were used to elaborate dietary patterns via the K-mean cluster analysis method. Frailty that accounted for 15% of the sample was twice as much in women (20%) than men (10%). Identified dietary patterns included a Westernized-type dietary pattern (WDP), a high intake/Mediterranean-type dietary pattern (HI-MEDDP), and a moderate intake/Mediterranean-type dietary pattern (MOD-MEDDP). In the multivariate analysis, age, waist to height ratio, polypharmacy, age-related conditions, and WDP were independently associated with frailty. In comparison to MOD-MEDDP, and after adjusting for covariates, adopting a WDP was strongly associated with a higher frailty prevalence in men (OR = 6.63, 95% (CI) (1.82–24.21) and in women (OR = 11.54, 95% (CI) (2.02–65.85). In conclusion, MOD-MEDDP was associated with the least prevalence of frailty, and WDP had the strongest association with frailty in this sample. In the Mediterranean sample, a diet far from the traditional one appears as the key deleterious determinant of frailty.

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Body mass index, frailty, and outcomes in heart failure with preserved ejection fraction

Li,

Wang,

Hua

et al. 2023

ESC Heart Failure

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AimsRelationship between body mass index (BMI), frailty, and clinical adverse events remains unclear in patients with heart failure (HF) with preserved ejection fraction (HFpEF) in different patient populations. We aimed to compare the association of BMI, frailty, and clinical adverse events between a US cohort from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study and a Chinese cohort from the Heart Failure Registry of Patient Outcomes (HERO) study.Methods and resultsWe used data of 1715 participants enrolled from America in the TOPCAT study and 1487 patients with HFpEF in the Chinese registry study, the HERO. We evaluated the relationship between BMI and frailty using multivariate restricted cubic spline logistic regression. Association between frailty and BMI categories and primary outcomes including HF hospitalization, aborted sudden death, and cardiovascular death, all‐cause mortality, and HF hospitalization were analysed by Cox proportional hazards models. The patients' mean age was 72 ± 11 years for both study populations, with 50% and 46% female for the TOPCAT study and the HERO study, respectively. Patients in the TOPCAT study had a higher mean BMI (33.9 vs. 24 kg/m2), with 72.3% vs. 52.9% defined as moderately to severely frail (frailty index > 0.3). In the TOPCAT study, risk of frailty rose as BMI increased, but not in the HERO study. Patients with frailty were at significant higher risk for the primary composite outcomes [hazard ratio (HR) 1.84 (95% confidence interval: 1.46–2.32)], all‐cause mortality [HR 1.73 (1.34–2.25)], and HF hospitalization [HR 1.83 (1.40–2.40)] in the TOPCAT study. The corresponding numbers in the HERO study were 1.26 (1.01–1.57), 2.21 (1.45–3.35), and 1.15 (0.81–1.37), respectively. The association of frailty with clinical outcomes did not vary with BMI categories in the two studies.ConclusionsBMI distribution and association between BMI and frailty risk were different between the two study populations. Frailty was associated with clinical adverse events and this association was consistent across different BMI categories in both studies.

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Mediating effect of waist:height ratio on the association between BMI and frailty: the Korean Frailty and Aging Cohort Study

Cited by 10 publications

References 42 publications

Body mass index and physical frailty among older Mexican Americans: Findings from an 18-year follow up

Body mass index and physical frailty among older Mexican Americans: Findings from an 18-year follow up

Dietary Patterns and Risk Factors of Frailty in Lebanese Older Adults

Body mass index, frailty, and outcomes in heart failure with preserved ejection fraction

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