Body mass index trajectories and functional decline in older adults: Three-City Dijon cohort study
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Obesity, whose prevalence is increasing, is associated with poor functional status at older ages. However, much of this evidence is cross-sectional with little known about longitudinal associations. We examined associations of body mass index (BMI), and change in BMI, with change in objective [walking speed (WS)] and self-reported (disability) measures of motor decline. Analyses included participants (65–85 years) from the Dijon center of the Three-City study (France) with up to five WS (N = 4007) and six disability assessments (N = 4478) over 11 years. Data were analyzed using regression models for repeated measures. Mean baseline WS was 153 cm/s. Compared to normal weight persons, obese participants at baseline walked slower and reported more disability; they also experienced 45 % faster WS decline (−18.63 vs. −12.85 cm/s/10 years, P = 0.002). Participants who lost or gained weight had 47 % (−18.85 cm/s/10 years, P < 0.001) and 33 % (−17.08 cm/s/10 years, P = 0.002) respectively greater WS decline than participants in the normal BMI change category. 24 % of participants reported disability at least once during the follow-up, those who lost or gained weight had a 1.63 and 1.34 respectively higher odds of disability than participants in the normal BMI change category (P = 0.001). Associations remained after adjustment for covariates. In conclusion, obesity is associated with worse motor performances, a higher risk of disability, and faster motor decline. Our results underline the interest of repeated BMI and motor assessments to identify those at higher risk of disability.
KeywordsAged Body mass index Cohort study Disability Epidemiology Motor decline
The 3C study was supported by a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Victor Segalen-Bordeaux II University, and the Sanofi-Synthélabo Company. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Conseils Régionaux of Bourgogne, Fondation de France, Ministry of Research-INSERM Program, “Cohortes et collections de données biologiques”, Mutuelle Générale de l’Education Nationale, Institut de la Longévité, Conseil Général de la Côte d’or, Fondation Plan Alzheimer. Fanny Artaud is the recipient of a doctoral grant from the EHESP (Ecole des Hautes Etudes en Santé Publique), Rennes, France. ASM receives research support from the US National Institutes of Health (R01AG013196, R01AG0344540).
Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377(9765):557–67.PubMedCentralCrossRefPubMedGoogle Scholar
- 5.Une enquête INSERM/Kantar Health/Roche. ObEpi 2012, Enquête épidémiologique nationale sur le surpoids et l’obésité. 2012.Google Scholar
- 9.Schaap LA, Koster A, Visser M. Adiposity, muscle mass, and muscle strength in relation to functional decline in older persons. Epidemiol Rev. 2013;35:51–65. Google Scholar
- 29.Rabe-Hesketh S, Skrondal A. Multilevel and longitudinal modeling using Stata. 2nd ed. Texas: Stata Press; 2005.Google Scholar