Dynapenic Abdominal Obesity as a Risk Factor for Worse Trajectories of ADL Disability Among Older Adults: The ELSA Cohort Study

Abstract

Background: 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 dynapenic abdominal obesity can result in worse trajectories of activities of daily living (ADL) over 8 years of follow-up.

Methods: We used longitudinal data from 3,723 participants free from ADL disability at baseline from the English Longitudinal Study of Ageing. Using measures of handgrip strength (<26 kg for men; <16 kg for women) and waist circumference (>102 cm for men; >88 cm for women), participants were classified into four groups: nondynapenic/nonabdominal obese (reference group), abdominal obese only, dynapenic only, and dynapenic abdominal obese. We used generalized linear mixed models with ADL as the outcome and the four groups according to dynapenia and abdominal obesity status as the main exposure controlled by sociodemographic, behavioral, and clinical characteristics.

Results: The estimated change over time in ADL disability was significantly higher for participants with dynapenic abdominal obesity compared with those with neither condition (+0.018, 95% CI: 0.008 to 0.027). Compared with the results of our main analysis (which took into account the combination of dynapenia and abdominal obesity on the rate of change in ADL), the results of our sensitivity analysis-which examined dynapenia and abdominal obesity only as independent conditions-showed an overestimation of the associations of dynapenia only and of abdominal obesity only on the ADL disability trajectories.

Conclusions: Dynapenic abdominal obesity is an important risk factor for functional decline in older adults.

Keywords: Disability; Dynapenia; Handgrip; Waist circumference; Weakness.

Figure 1.

Trajectories of ADL disability according to dynapenia and abdominal obesity status—ELSA study 2004–2012. Abbreviations: ADL = activities of daily living; ELSA = English Longitudinal Study of Ageing.