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. 2012 Sep;60(9):1695-700.
doi: 10.1111/j.1532-5415.2012.04101.x.

Resting metabolic rate in old-old women with and without frailty: variability and estimation of energy requirements

Carlos O Weiss  1 , Anne R Cappola, Ravi Varadhan, Linda P Fried
Affiliations

Resting metabolic rate in old-old women with and without frailty: variability and estimation of energy requirements

Carlos O Weiss et al. J Am Geriatr Soc. 2012 Sep.

Abstract

Objectives: To measure resting metabolic rate (RMR) in old-old adults living in the community and examine the association between measured RMR and frailty status and compare it with expected RMR generated by a predictive equation.

Design: Physiological substudy conducted as a home visit within an observational cohort study.

Setting: Baltimore City and County, Maryland.

Participants: Seventy-seven women aged 83 to 93 enrolled in the Women's Health and Aging Study II.

Measurements: Resting metabolic rate with indirect calorimetry, frailty status, fat-free mass, ambient and body temperature, expected RMR according to the Mifflin-St. Jeor equation.

Results: Average RMR was 1,119 ± 205 kcal/d (range 595-1,560 kcal/d). Agreement between observed and expected RMR was biased and poor (between-subject coefficient of variation 38.0%, 95% confidence interval = 35.1-40.8). Variability of RMR was greater in frail individuals (heteroscedasticity F-test P = .02). Low and high RMR were associated with being frail (odds ratio 5.4, P = .04) and slower self-selected walking speed (P < .001) after adjustment for covariates.

Conclusion: Equations to predict RMR that are not validated in old-old adults appear to correlate poorly with measured RMR. RMR is highly variable in old-old women, with deviations from the mean predicting clinical frailty. These exploratory findings suggest a pathway to clinical frailty through high or low RMR.

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Figures

Figure 1
Figure 1. Distribution of Resting Metabolic Rate, According to Frailty Status
RMR is resting metabolic rate. Two people identified by filled squares were fasting <10 hours. Horizontal lines are 25th and 75th percentiles for the sample.
Figure 2
Figure 2. Association Between Resting Metabolic Rate and Self-Selected Walking Speed, a Cardinal Feature of Frailty
RMR is resting metabolic rate and was adjusted for height, weight, body temperature and ambient temperature. Two people identified by filled squares were fasting <10 hours. Line is fitted from model adjusting for height, weight, ambient temperature and body temperature (equation y=0.684+RMR*0.00248+RMR*-0.00875).
Figure 3
Figure 3. Agreement Between Observed and Expected Resting Metabolic Rate. RMR is resting metabolic rate
Two people identified by filled squares were fasting <10 hours.
See this image and copyright information in PMC

Comment in

  • Aging and the energetic cost of life.
    Ferrucci L, Schrack JA, Knuth ND, Simonsick EM. Ferrucci L, et al. J Am Geriatr Soc. 2012 Sep;60(9):1768-9. doi: 10.1111/j.1532-5415.2012.04102.x. J Am Geriatr Soc. 2012. PMID: 22985146 Free PMC article. No abstract available.

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