Abdominal Obesity and Mobility Disability in Older Adults: A 4-Year Follow-Up the International Mobility in Aging Study

Sociodemographic Factors Associated with Physical Functioning in Elderly Males and Females from Serbia: Population-Based Modeling Study

Background and aim: During the past few decades, the aging population has increased. With aging, there is an increase in functional limitations. The aim of this study was to analyze sociodemographic factors associated with physical functioning impairment in elderly males and females. Methods: This population-based modeling study based on a data from a third national study of health of Serbian inhabitants from 2013 in Serbia included 3540 elderly participants 65 years of age and above from Serbia. Physical functioning for both genders was categorized as follows: PF1-walking half a kilometer on level ground without the assistance of any mobility aids and PF2-walking up or down 12 steps. Modeling of physical functioning for both genders was categorized as follows: Model 1: inability to perform PF1, Model 2: some/a lot of difficulty in performing PF1, Model 3: inability to perform PF2, and Model 4: some/a lot of difficulty in performing PF2. Further variables were evaluated: age, education level, marital status, body mass index (BMI), wealth index, and place of residence. Logistic regression was performed to identify the variables that are factors associated with PF1 and PF2 in elderly males and females. Results: Statistically significant factors were as follows: age (Model 1 (male OR: 2.591; female OR: 4.708); Model 2 (male OR: 1.791; female OR: 2.354); Model 3 (male OR: 2.386; female OR: 4.985); Model 4 (male OR: 1.883; female OR: 2.772)); BMI (Model 2 (female OR: 1.348); Model 4 (female OR: 1.329)), marital status (Model 2 (female OR: 0.713); Model 4 (male OR: 0.688)); education level (Model 1 (male OR: 0.626; female OR: 0.537); Model 2 (male OR: 0.811; female OR: 0.653); Model 3 (male OR: 0.697; female OR: 0.494); Model 4 (male OR: 0.784; female OR: 0.639)); wealth index (Model 2 (male OR: 0.823; female OR: 0.740); Model 3 (male OR: 0.724); Model 4 (male OR: 0.787; female OR: 0.731)); and place of residence (Model 1 (female OR: 1.704); Model 3 (female OR: 1.575)). Conclusions: Increased age, being single, a lower education level, and a lower wealth index were factors associated with functional disability in the elderly of both genders, while an increased BMI and living in another place than a city were factors associated with functional disability in elderly females. Specific social strategies bearing in mind possible gender differences should be created and implemented in order to optimize the physical functioning, mobility, and participation of the elderly.

Association between central obesity and ADL impairment among the middle-aged and elderly population in China based on CHARLS

To explore the associations of central obesity indicators including waist circumference (WC), waist-to-height ratio (WHtR), and weight-adjusted waist index (WWI) with the impairment of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) among middle-aged and elderly population in China. This prospective study used baseline data from 2011 and follow-up data, involving 6440 and 9646 participants, respectively. Binary logistic regression analysis was used to assess the relationships. Restricted cubic spline (RCS) curve was also used to analyze the correlation trends. Stratified analyses were performed to identify potential differences. Receiver operating characteristic curves were plotted to evaluate the predictive value of each indicator. WC (OR = 1.01, 95% CI:1.01-1.02), WHtR (OR = 1.21, 95% CI = 1.09-1.33), and WWI (OR = 1.10, 95% CI:1.02-1.19) were significantly associated with BADL impairment. Only WWI (OR = 1.16, 95%CI:1.09-1.23) was associated with IADL impairment. WC, WHtR and WWI were linearly associated with BADL impairment while WWI was linearly associated with IADL impairment. The risk association between WWI and BADL was stronger in drinking individuals and males. In the participants with a BMI less than 24 kg/m² and who had received a high school education or above, the increase in WWI was accompanied by a more significant risk of IADL impairment. The predictive ability of WWI is higher than that of WC and WHtR, with AUC values of 0.597 and 0.615. WWI, as a comprehensive indicator of central obesity, may be useful in comprehensively identifying the risk of early daily living activity impairment among middle-aged and elderly population.

Effect of gut symbiotic bacteria Akkermansia muciniphila on aging-related obesity

Recent studies have shown that Akkermansia muciniphila may play a role in regulating lipid metabolism and immune response in diet-induced obese mice. However, in contrast to diet-induced obesity, aging-related obesity is characterized by a gradual increase in body fat proportion over time. This type of obesity is thought to be caused by a combination of factors, including slow metabolism, unhealthy lifestyle choices, and chronic inflammation. Unlike diet-induced obesity, which can occur relatively quickly, aging-related obesity is a long-term and slow process. In this study, we administered Akkermansia muciniphila to aged mice and collected fecal samples to analyze the targeted metabolism of short chain fatty acids (SCFAs). The mice were then euthanized and their abdominal fat was weighed. hematoxylin-eosin (H&E) staining was performed to examine tissue samples. quantitative polymerase chain reaction (qPCR) was used to detect the expression of IL-6 and TNF-α. Flow cytometry was used to examine the proportion of lymphocytes. Enzyme-linked immunosorbent assays (ELISAs) kits were used to measure the levels of inflammatory factors and aging-related indicators. The results indicate that following intragastric administration, the body weight of the aged mice decreased, along with a decrease in abdominal fat and a reduction in the size of fat cells. Additionally, there was a decrease in the mRNA level of inflammatory factors, a decrease in the total number of immune cells in abdominal fat, and a decrease in the proportion of CD8+ CD4-cells. In addition, our findings showed that serum levels of IL-6, TNF-α, and lipopolysaccharide (LPS) were reduced, and catalase (CAT) and thyroid-stimulating hormone (TSH) levels were comparable to those of young mice. The findings revealed that Akkermansia muciniphila has the potential to enhance immune regulation in aged mice, alleviate persistent inflammation, and decrease obesity in this aged mice.

Influence of Obesity and Sociodemographic Features on the Physical Fitness of Breast Cancer Survivors

INTRODUCTION

Obesity is a chronic, relapsing, and progressive disease. The issue of obesity affects 50 to 80% of patients who have been diagnosed with breast cancer. The aim of this study is to assess the scale of the problem of obesity among breast cancer survivors (BCS) older than 60 years, evaluate their physical fitness, and study the relationship between the occurrence of obesity and levels of fitness among breast cancer survivors. The relationship between fitness and sociodemographic factors has also been analyzed.

MATERIALS AND METHODS

This original epidemiological clinical study included a cohort of 88 female breast cancer survivors treated in 2022 in Holycross Cancer Center, Kielce, Poland. A questionnaire involving demographic information and medical data was utilized. The Senior Fitness Test (SFT) battery has been used to assess the physical fitness of the patients. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were also analyzed.

RESULTS

More than 70% of the studied breast cancer survivors were classified as overweight or obese, according to BMI and WC indices. Depending on the SFT trial, the regression coefficients indicated worse results in participants who were older, lived in urban areas, were professionally active, less educated, and had higher obesity indices. The analysis of the relationship between obesity indices and fitness components revealed that all obesity indices were significantly associated with lower body flexibility (BMI p = 0.0118, WC p = 0.0092, WHR p = 0.0364, WHtR p = 0.0095). Upper body flexibility was significantly correlated with BMI indices (p = 0.0091, p = 0.0193) and WHtR (p = 0.0095). Agility and balance were significantly associated with WC (p = 0.0193), WHR (p = 0.098), and WHtR (p = 0.0095). Lower body strength was significantly correlated with the WHR index (p = 0.0487). Significant differences were found in upper body strength depending on the WHtR category.

CONCLUSIONS

In the studied group of breast cancer survivors, there is a high prevalence of overweight and obesity. With increasing obesity rates, older age, and lower education levels, physical activity measured by the SFT decreases. Living in urban areas and being professionally active also predispose to lower physical activity levels. As obesity indices increase, physical fitness decreases in trials assessing upper and lower body strength, upper and lower body flexibility, as well as agility and dynamic balance.

Overweight in Older Adults: A Follow-Up of Fifteen Years of the SABE Survey

Despite extensive research on overweight and obesity, there are few studies that present longitudinal statistical analyses among non-institutionalized older adults, particularly in low- and middle-income countries. This study aimed to assess the prevalence and factors associated with excess weight in older adults from the same cohort over a period of fifteen years. A total of 264 subjects aged (≥60 years) from the SABE survey (Health, Wellbeing and Aging) in the years 2000, 2006, 2010, and 2015 in the city of São Paulo, Brazil, were evaluated. Overweight was assessed by a BMI of ≥28 kg/m². Multinomial logistic regression models adjusted for sociodemographic and health data were used to assess factors associated with excess weight. After normal weight, overweight was the most prevalent nutritional status in all evaluated periods: 34.02% in 2000 (95%CI: 28.29-40.26); 34.86% in 2006 (95%CI: 28.77-41.49%); 41.38% in 2010 (95%CI: 35.25-47.79); 33.75% in 2015 (95%CI: 28.02-40.01). Being male was negatively associated with being overweight in all years (OR: 0.34 in 2000; OR: 0.36 in 2006; OR: 0.27 in 2010; and OR: 0.43 in 2015). A greater number of chronic diseases and worse functionality were the main factors associated with overweight, regardless of gender, age, marital status, education, physical activity, and alcohol or tobacco consumption. Older adults with overweight and obesity, a greater number of chronic diseases, and difficulties in carrying out daily tasks required a greater commitment to healthcare. Health services must be prepared to accommodate this rapidly growing population in low- and middle-income countries.

Gender and physical frailty modify the association between abdominal obesity and functional disability in older adults

BACKGROUND

Abdominal obesity is associated with functional disability in older adults.

AIM

We evaluated whether this association was modified by gender and/or physical frailty.

METHODS

We used cross-sectional data from 12,583 participants in the third follow-up of the population-based Singapore Chinese Health Study, when participants had mean age of 74 years (range 63-97). Abdominal obesity was defined using waist circumference, physical frailty was established using the modified Cardiovascular Health Study phenotype, and functional disability was determined by the Lawton Instrumental Activities of Daily Living Scale. We used logistic regression models to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between abdominal obesity and disability.

RESULTS

Abdominal obesity was associated with increased likelihood of functional disability, and this association was stronger in women than in men [OR (95% CI): 1.27 (1.11-1.46) vs. 1.08 (0.93-1.25); P for interaction < 0.001]. Furthermore, there was a significantly stronger association between abdominal obesity and functional disability in participants who were physically frail compared to those who were not [OR (95% CI): 1.57 (1.19-2.08) vs. 1.11 (0.99-1.23); P for interaction = 0.003], and this phenomenon was observed in both genders. When compared to participants who were neither abdominally obese nor physically frail, participants who were both abdominally obese and physically frail had a synergistically increased risk of functional disability [OR (95% CI): 3.61 (3.03-4.30)].

CONCLUSIONS

Women with abdominal obesity had higher risk of functional disability compared to men, and older adults who were both abdominally obese and physically frail had a synergistically increased risk of disability.

Metabolic syndrome and its association with components of sarcopenia in older community-dwelling Chinese

Aging and obesity contribute to muscle dysfunction. This study aimed to determine the cross-sectional associations between components of metabolic syndrome (MetS) and sarcopenia in 251 older community-dwelling Chinese. The total fat-free mass was measured by dual-energy X-ray absorptiometry, muscle strength (handgrip strength) by a handheld dynamometer, physical performance by 4-meter walk, 5-time chair stand test, and the short physical performance battery (SPPB). MetS was defined using the International Diabetes Federation (IDF) criteria. The participants with MetS had a higher appendicular skeletal muscle mass (ASM) and relative ASM (RASM). The males with MetS had higher handgrip strength, and the females with MetS had higher SPPB scores. After adjusting for age and body mass index, the participants with an increased waist circumference had a higher ASM, and those with increased diastolic blood pressure (DBP) also had higher handgrip strength. The males with elevated fasting blood glucose (FBG) levels had a lower gait speed. Components of MetS, such as DPB and FBG, were associated with muscle strength and physical performance in older adults. These results suggest that muscle strength and function should be considered in treating older adults with MetS.

Factors Associated With Obesity and Abdominal Obesity Among Malaysian Older Adults

Obesity is a rising concern globally. This study investigated the prevalence and factors associated with obesity and abdominal obesity (AO) among 5613 Malaysians aged 40 years and older via computer-assisted personal interviewing and anthropometric measurements. Obesity and AO prevalence were 37.8% and 63.1%, respectively. Significant associations were observed between: obesity with higher risk in patients aged between 40 and 49 years, Indians, females, income ≥RM 2000, and health status, and AO with higher risk in patients aged between 50 and 59 years, Indians, females, never married, income ≥RM 2000, and vigorous physical activity. Hence, age, sex, income, and ethnicity are associated with both obesity and AO. Promoting healthy body mass index and waist circumference is essential for healthy ageing.

Sarcopenic obesity and function in women with subacute hip fracture: a short-term prospective study

BACKGROUND

The prognostic role exerted by the concurrent presence of sarcopenia and obesity after hip fracture has not been elucidated.

AIM

To assess the effect of sarcopenic obesity on ability to function in women with subacute hip fracture.

DESIGN

Short-term prospective study.

SETTING

Rehabilitation hospital.

POPULATION

Women with subacute hip fracture.

METHODS

At admission, grip strength, by a Jamar dynamometer, and body composition by dual-energy x-ray absorptiometry were assessed. Sarcopenia was defined according to the criteria released by the European Working Group for Sarcopenia in Older People in 2019, with both grip strength < 16kg and appendicular lean mass (aLM) < 15kg. Alternatively, aLM/(height)2 < 5.5kg/m2 was substituted for aLM < 15kg to confirm sarcopenia in the women with grip strength < 16kg. Obesity was diagnosed with fat mass exceeding 40% of total body mass. Function was assessed by the Barthel index.

RESULTS

We assessed 183 of 200 women. Sarcopenic women had lower Barthel index scores assessed at the end of subacute inpatient rehabilitation (U=300,0; z=-4.3; P<0.001) and lower Batrhel index effectiveness (U=310,0; z=-4.2; P<0.001) than non-sarcopenic women. Conversely, we found no significant differences in function between obese and non-obese women. The concurrent presence of sarcopenia and obesity did not worsen the functional prognosis versus the presence of isolated sarcopenia. After adjustment for Barthel index scores before rehabilitation, age, hip-fracture type and cognitive impairment, sarcopenia was significantly associated with Barthel index scores (P=0.001) and Barthel index effectiveness (P<0.001), whereas obesity was not. The results did not materially change when aLM/(height)2 < 5.5kg/m2 was substituted for aLM <15kg to confirm sarcopenia in the women whose handgrip strength was < 16kg.

CONCLUSIONS

The concurrent presence of obesity did not worsen the negative prognostic role of sarcopenia in the short-term recovery of ability to function after hip fracture in women.

CLINICAL REHABILITATION IMPACT

In women with subacute hip fracture, sarcopenia but not obesity should be assessed to contribute to the prediction of the short-term functional outcome.

Antiobesity Effects of Adipose-Derived Stromal/Stem Cells in a Naturally Aged Mouse Model

OBJECTIVE

Adipose-derived stromal/stem cells (ASCs) have multilineage differentiation potential and functional properties, as well as applications for cell-based therapies in tissue repair and regeneration. However, there is a lack of evidence regarding the efficacy of ASCs as an antiobesity agent in aged organisms. This study aimed to clarify the effectiveness of ASCs at treating obesity using a naturally aged mouse model.

METHODS

Old (22 months) C57BL/6J mice with transplanted young-mice (2 months) donor ASCs were measured for weight change, biochemistry, cytokines, hormone secretion, cell senescence, lipid metabolism, and functional changes of ASCs.

RESULTS

The results indicated that old mice treated with ASCs showed antiaging and antiobesity effects such as significant loss of body and organ weight, improved stem cell plasticity, increased antioxidant capacity (superoxide dismutase and catalase), improved liver and kidney function, improved lipid metabolism, and increased hormone secretion (sex hormone-binding globulin, thyrotropin, and leptin). Treatment with ASCs decreased cell senescence and suppressed secretion of inflammatory agents (interleukin-6 and tumor necrosis factor alpha).

CONCLUSIONS

Traditional drugs used in the treatment of obesity have limitations and are unsuitable for the elderly. Based on the results, the future use of ASCs as primary antiaging and antiobesity agents is suggested because of their positive effects on aged animals.

The Associations between Functional Fitness Test Performance and Abdominal Obesity in Healthy Elderly People: Results from the National Physical Fitness Examination Survey in Taiwan

The relationships between different functional fitness performance and abdominal obesity among the elderly have not been widely discussed in the literature. The present study aimed to investigate the associations between functional fitness test performance and abdominal obesity in Taiwanese elderly people. A total of 22,399 items of data from the National Physical Fitness Survey Databases in Taiwan (NPFSD 2014-15) were reviewed and analyzed. The quartiles of functional fitness test results were identified as the dependent variable in the multiple linear regression analysis to examine the association between functional fitness and abdominal obesity status. The results showed that body balance (odds ratios (ORs) listed from 1.18 to 2.29, p < 0.05) and flexibility (ORs listed from 1.23 to 2.16, p < 0.05) were critically associated with abdominal obesity. However, measurements related to muscle strength revealed the limited effect sizes for abdominal obesity. From a disability prevention perspective, the development of muscle strength in the elderly should be emphasized and encouraged to maintain their daily capabilities instead of satisfaction with a lean body.

Nutritional status related to poor health outcomes in older people: Which is better, obese or lean?

Good nutritional status is crucial for maintaining growth and health in all stages of life. However, the relationship between nutritional status and health and the effect on various health-related outcomes differ, depending on the life stage. Many adverse outcomes in older adults, directly linked to different nutritional status, are not present in middle-aged adults, and their ideal nutritional status may differ. This article will review the optimal nutritional status, mainly evaluated by anthropometric measurements such as body mass index, for older adults from various perspectives. Overall, in older adults low body mass index is at higher risk of health problems such as mortality and difficulties in physical functioning compared with middle-aged adults, reducing the risk of health problems for overweight and (abdominal) obesity. Overweight may be more beneficial than lower level of normal weight in older-old and vulnerable older people. While, with or without obesity, skeletal muscle loss or weakness as well as unintentional weight loss induces health problems in older adults. The impact of metabolic syndrome on the prognosis of older adults is clearly reduced compared with middle-aged adults, requiring a shift in medical attention in older adults from metabolic syndrome to frailty. There are still many unclear points regarding the optimal nutritional status of older people, and further research is needed to support healthy longevity. Geriatr Gerontol Int 2021; 21: 5-13.

Aging and Imaging Assessment of Body Composition: From Fat to Facts

The aging process is characterized by the chronic inflammatory status called "inflammaging", which shares major molecular and cellular features with the metabolism-induced inflammation called "metaflammation." Metaflammation is mainly driven by overnutrition and nutrient excess, but other contributing factors are metabolic modifications related to the specific body composition (BC) changes occurring with age. The aging process is indeed characterized by an increase in body total fat mass and a concomitant decrease in lean mass and bone density, that are independent from general and physiological fluctuations in weight and body mass index (BMI). Body adiposity is also re-distributed with age, resulting in a general increase in trunk fat (mainly abdominal fat) and a reduction in appendicular fat (mainly subcutaneous fat). Moreover, the accumulation of fat infiltration in organs such as liver and muscles also increases in elderly, while subcutaneous fat mass tends to decrease. These specific variations in BC are considered risk factors for the major age-related diseases, such as cardiovascular diseases, type 2 diabetes, sarcopenia and osteoporosis, and can predispose to disabilities. Thus, the maintenance of a balance rate of fat, muscle and bone is crucial to preserve metabolic homeostasis and a health status, positively contributing to a successful aging. For this reason, a detailed assessment of BC in elderly is critical and could be an additional preventive personalized strategy for age-related diseases. Despite BMI and other clinical measures, such as waist circumference measurement, waist-hip ratio, underwater weighing and bioelectrical impedance, are widely used as a surrogate measure for body adiposity, they barely reflect the distribution of body fat. Because of the great advantages offered by imaging tools in research and clinics, the attention of clinicians is now moving to powerful imaging techniques such as computed tomography, magnetic resonance imaging, dual-energy X-ray absorptiometry and ultrasound to obtain a more accurate estimation of BC. The aim of this review is to present the state of the art of the imaging techniques that are currently available to measure BC and that can be applied to the study of BC changes in the elderly, outlining advantages and disadvantages of each technique.