Dataset Information

The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults.

ABSTRACT: BACKGROUND/OBJECTIVES:The concept of dynapenic obesity has been gaining great attention recently. However, there is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenia combined with abdominal obesity can result in worse trajectories of instrumental activities of daily living (IADL) among English and Brazilian older adults over eight and ten years of follow-up, respectively. METHODS:We used longitudinal data from 3374 participants from the English Longitudinal Study of Ageing (ELSA) and 1040 participants from the Brazilian Health, Well-being and Aging Study (SABE) who were free from disability as assessed by IADL at baseline. IADL disability was defined herein as a difficulty to perform the following: preparing meals, managing money, using transportation, shopping, using the telephone, house cleaning, washing clothes, and taking medications according to the Lawton IADL modified scale. The study population in each country was categorized into non-dynapenic/non-abdominal obese (reference group), abdominal obese, dynapenic and dynapenic abdominal obese according to their handgrip strength (<26 kg for men and <16 kg for women) and waist circumference (>102 cm for men and >88 cm for women). We used generalized linear mixed models with IADL as the outcome. RESULTS:The estimated change over time in IADL disability was significantly higher for participants with dynapenic abdominal obesity compared to those with neither condition in both cohorts (ELSA: +0.023, 95% CI = 0.012-0.034, p < 0.001; SABE: +0.065, 95% CI = 0.038-0.091, p < 0.001). Abdominal obesity was also associated with changes over time in IADL disability (ELSA: +0.009, 95% CI = 0.002-0.015, p < 0.05; SABE: +0.021, 95% CI = 0.002-0.041, p < 0.05), which was not observed for dynapenia. CONCLUSIONS:Abdominal obesity is an important risk factor for IADL decline but participants with dynapenic abdominal obesity had the highest rates of IADL decline over time among English and Brazilian older adults.

SUBMITTER: Alexandre TDS

PROVIDER: S-EPMC6013360 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults.

Alexandre Tiago da Silva TDS Scholes Shaun S Ferreira Santos Jair Licio JL Duarte Yeda Aparecida de Oliveira YAO de Oliveira Cesar C

Clinical nutrition (Edinburgh, Scotland) 20171002 6 Pt A

<h4>Background/objectives</h4>The concept of dynapenic obesity has been gaining great attention recently. However, there is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenia combined with abdominal obesity can result in worse trajectories of instrumental activities of daily living (IADL) among English and Brazilian older ...[more]

PMID: 29033231

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Project description:ObjectiveThe inter-individual variability in cognitive changes may be early indicators of major health events. We aimed to determine whether late-life cognitive trajectories were associated with incident dementia, persistent physical disability and all-cause mortality.MethodsData came from a cohort of older community-dwelling individuals aged 70 years or above in Australia and the United States. Global cognition, verbal fluency, episodic memory and psychomotor speed were assessed regularly at up to seven waves between 2010 and 2017. Dementia, disability in activities of daily living, and death were adjudicated between 2017 and 2020. Latent classes of cognitive trajectories over seven years were determined using group-based trajectory modeling. Multivariable logistic regression was used for the prospective associations between cognitive trajectories and these outcomes.ResultsCognitive trajectories were defined for 16,174 participants (mean age: 78.9 years; 56.7% female) who were alive and without incident dementia or disability by 2017, among which 14,655 participants were included in the association analysis. Between three and five trajectory classes were identified depending on the cognitive test. Cognitive trajectories were strongly associated with the risk of dementia. For example, compared to those in the highest-functioning trajectory, the worst performers of episodic memory had a 37-fold increased risk of dementia (95% CI: 17.23-82.64). The lowest trajectories of both global cognition and episodic memory also predicted increased mortality risk (OR: 1.80, 95% CI: 1.28-2.52; OR: 1.61, 95% CI: 1.09-2.36, respectively), while only slow psychomotor speed was marginally associated with physical disability (OR: 2.39, 95% CI: 0.99-5.77).ConclusionsIn older individuals, cognitive trajectories appear to be early indicators of clinically relevant health outcomes. Systematic cognitive assessments as part of routine geriatric evaluation may facilitate early identification and interventions for those individuals at highest risk.

Dataset Information

The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults.

Publications

The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults.

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