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Physical function mitigates the adverse effects of being thin On mortality in a free-living older Taiwanese cohort

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To examine the significance of underweight and physical function as well as their interaction on mortality in the aged.

Design

Prospective cohort.

Setting

The Elderly Nutrition and Health Survey in Taiwan during 1999–2000.

Participants

Total of 1435 representative free-living elders (739 men and 696 women).

Measurements

Body composition was assessed by various anthropometrics. Physical function score (PF, ranged 0–100) was derived from the SF-36®. Death by December 31, 2006 was the outcome measure.

Results

After 7.9 (median: 7.0) years follow-up, 381 (223 men, 158 women) of 1435 eligible participants had died. Those with the lowest PF (<45) had 3.43 (hazards ratio (HR), 95% confidence interval (CI) = 2.20–5.36) times the all-cause mortality risk of the highest PF (≥58). Interactions for PF and BMI (P =0.02) and for PF and wrist circumference (P =0.09) on death were found after controlling for potential confounders. Jointly, compared to normal-BMI-highest-PF, the greatest HR for death occurred where BMI <18.5 kg/m2 was combined with the lowest-PF after covariate adjustments (HR = 8.67, 95% CI = 3.77–20.0). Similarly, the lowest arm muscle circumference (MAMC)-PF had a HR of 5.22 compared to mid-MAMC-highest-PF. However, percent and absolute body fat, estimated by bioelectrical impedance, was comparable to non-sarcopenic individuals.

Conclusion

Thin elderly Taiwanese with sarcopenia, and less skeleton, are at the most risk of death, especially if physical function is limited.

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Abbreviations

CED:

Chronic energy deficiency

NAHSIT:

Nutrition and Health Survey in Taiwan

IQOLA:

International Quality of Life Assessment

SF-36:

36 item Short Form

PF:

Physical functioning

WC:

Waist circumference

MAC:

Mid-arm circumference

TSF:

Triceps skinfold thickness

BMI:

Body mass index

MAMC:

Mid-arm muscle circumference

% BF:

Percent body fat

% BW:

Percent body water

HR:

Hazard ratio

PCS:

Physical component score

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Authors and Affiliations

  1. School of Public Health, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 114, Taiwan, ROC

    M. -S. Lee & Mark L. Wahlqvist

  2. Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 350, Taiwan, ROC

    R. C. -Y. Chen, Y. -C. Huang & Mark L. Wahlqvist

  3. Division of Health Policy Translation, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County, 350, Taiwan, ROC

    Y. -H. Chang

  4. Asia Pacific Health and Nutrition Centre, Monash Asia Institute, Monash University, 5th Floor, H Building, 900 Dandenong Road, Caulfield East, Melbourne, Victoria, 3145, Australia

    M. -S. Lee & Mark L. Wahlqvist

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  1. M. -S. Lee
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  2. R. C. -Y. Chen
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  3. Y. -H. Chang
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  4. Y. -C. Huang
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  5. Mark L. Wahlqvist
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Correspondence to Mark L. Wahlqvist.

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Lee, M.S., Chen, R.C.Y., Chang, Y.H. et al. Physical function mitigates the adverse effects of being thin On mortality in a free-living older Taiwanese cohort. J Nutr Health Aging 16, 776–783 (2012). https://doi.org/10.1007/s12603-012-0379-3

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  • DOI: https://doi.org/10.1007/s12603-012-0379-3

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