American Journal of Epidemiology Advance Access originally published online on July 3, 2006
American Journal of Epidemiology 2006 164(5):459-469; doi:10.1093/aje/kwj217
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Original Contribution |
The Relations of Body Composition and Adiposity Measures to Ill Health and Physical Disability in Elderly Men
1 Department of Primary Care and Population Sciences, Royal Free Hospital and University College Medical School, London, United Kingdom
2 Department of Community Health Sciences, St. George's University of London, London, United Kingdom
Correspondence to Dr. Sheena E. Ramsay, Department of Primary Care and Population Sciences, Royal Free Hospital and University College Medical School, Rowland Hill Street, London NW3 2PF, United Kingdom (e-mail: s.ramsay{at}pcps.ucl.ac.uk).
Although body build is related to disability and mortality in older people, the independent contributions of adiposity and lean mass are not fully defined. The authors examined the relations of body composition (fat mass index, fat-free mass index) and adiposity (body mass index, waist circumference) to ill health and physical disability in a cross-sectional study of 4,252 British men aged 60–79 years in 1998–2000. Increased body mass index, waist circumference, and fat mass index were associated with increased prevalence of cardiovascular disease, overall ill health, and disability. Adjusted odds ratios of cardiovascular disease (top vs. bottom fifth) were 1.58 (95% confidence interval (CI): 1.23, 2.03) for fat mass index, 1.45 (95% CI: 1.14, 1.86) for body mass index, and 1.27 (95% CI: 0.99, 1.62) for waist circumference. For overall "poor/fair" health, the corresponding odds ratios were 1.71 (95% CI: 1.33, 2.21), 1.49 (95% CI: 1.17, 1.90), and 1.64 (95% CI: 1.28, 2.09) and, for mobility limitation, they were 1.56 (95% CI: 1.17, 2.06), 1.96 (95% CI: 1.48, 2.56), and 1.88 (95% CI: 1.42, 2.49). A high fat-free mass index was associated with only a decreased prevalence of respiratory problems and cancer (odds ratios = 0.45 (95% CI: 0.33, 0.62) and 0.62 (95% CI: 0.42, 0.94), respectively). Body fatness, not fat-free mass, is associated with cardiovascular disease and disability in older men. Simple measures of overweight, such as body mass index and waist circumference, are good indicators of the likelihood of morbidity in older men. Prevention of weight gain with increasing age is likely to reduce morbidity and disability among older men.
body composition; body mass index; chronic disease; mobility limitation
Abbreviations: BNF, British National Formulary; CI, confidence interval; FEV1, forced expiratory volume in 1 second; HDL-C, high density lipoprotein cholesterol
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