Waist circumference is a better predictor of risk for frailty than BMI in the community-dwelling elderly in Beijing

  • Qiuju Liao
  • Zheng Zheng
  • Shuangling Xiu
  • Piu Chan
Original Article



Obesity is found to be associated with frailty. Body mass index (BMI) and waist circumference (WC) are the commonly used measures for obesity, the former is more closely related to general obesity and body weight; the latter can more accurately reflect abdominal obesity and is more closely associated with metabolic disorders. In this study, we intend to study the relationship between frailty, BMI and WC among older people.


Data were derived from the Beijing Longitudinal Study on Aging II Cohort, which included 6320 people 65 years or older from three urban districts in Beijing. A Frailty Index derived from 33 items was developed according to Rockwood’s cumulative deficits method. A Frailty Index ≥ 0.25 was used as the cut-off criteria. BMI was classified as underweight, normal, overweight, or obese (< 18.5, 18.5–< 24.0, 24.0–27.9, ≥ 28.0 kg/m2, respectively). High WC was defined as WC ≥ 85 cm in men and ≥ 80 cm in women.


People with a larger BMI (≥ 28.0 kg/m2, 22.6%) or a larger WC (18.5%) were more likely to be frail. People with normal BMI and overweight people do not suffer from higher prevalence for frailty. In comparison with individuals with normal BMI (18.5–< 24.0 kg/m2) and normal WC (< 85 cm in men, <80 cm in women), the risk of frailty was higher among individuals who have normal BMI and large WC (odds ratio 1.68; 95% CI 1.33–2.12), have overweight and large WC (odds ratio 1.58; 95% CI 1.23–1.96), or have obesity and large WC (odds ratio 2.28; 95% CI 1.79–2.89). In people with normal WC, only those who are underweight have a higher risk for frailty (odds ratio 1.65, 95% CI 1.08–2.52). In comparison with BMI, the relation of WC with the risk for frailty was much closer.


Abdominal obesity is more closely associated with incidence of frailty than general obesity in the elderly. Older adults with large waist circumference are more likely to be frail. Frailty in the elderly might be more closely related to metabolic disorders. WC might be a better measurement to detect frailty than BMI, given its relationship with metabolic disorders.


Body mass index Waist circumference Frailty Older adults Prevalence 



This project was funded by grants from the Beijing Municipal Commission on Science and Technology (D07050701130000 and D07050701130701), and Ministry of Health of China (201002011), Ministry of Science and Technology of China (2012AA02A514, 0S2012GR0150, 2012ZX09303-005). We thank all the participants and their families and the healthcare professionals involved.

Author contribution

Study concept and design: Dr. Piu Chan, Dr. Qiuju Liao; acquisition of subjects and/or data: Dr. Piu Chan; analysis and interpretation of data: Dr. QiujuLiao, Dr. Zheng Zheng, Dr. Shuangling Xiu; preparation of manuscript: Dr. Piu Chan, Dr. Qiuju Liao.


This project was funded by grants from the Beijing Municipal Commission on Science and Technology (D07050701130000 and D07050701130701), and Ministry of Health of China (201002011), Ministry of Science and Technology of China (2012AA02A514, 0S2012GR0150, 2012ZX09303-005).

Compliance with ethical standards

Conflict of interest

No potential conflicts of interest were disclosed.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Research Ethics Committee of Xuanwu Hospital, Capital Medical University. In addition, this study was performed in accordance with the ethical principles of the Declaration of Helsinki.

Informed consent

Written informed consent was obtained from all participants.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Qiuju Liao
    • 2
    • 4
  • Zheng Zheng
    • 1
    • 2
    • 6
  • Shuangling Xiu
    • 2
    • 5
  • Piu Chan
    • 1
    • 2
    • 3
    • 6
  1. 1.Department of Neurobiology, Beijing Institute of GeriatricsXuanwu Hospital of Capital Medical UniversityBeijingChina
  2. 2.Department of Geriatrics, Beijing Institute of GeriatricsXuanwu Hospital of Capital Medical UniversityBeijingChina
  3. 3.Department of Neurology, Beijing Institute of GeriatricsXuanwu Hospital of Capital Medical UniversityBeijingChina
  4. 4.Department of Rheumatology, Beijing Institute of GeriatricsXuanwu Hospital of Capital Medical UniversityBeijingChina
  5. 5.Department of Endocrinology, Beijing Institute of GeriatricsXuanwu Hospital of Capital Medical UniversityBeijingChina
  6. 6.Key Laboratory on Neurodegenerative Disease of Ministry of Education, and Beijing Key Laboratory for Parkinson’s DiseaseParkinson’s Disease Center of Beijing Institute for Brain DisordersBeijingChina

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