Skip to main content
SpringerLink
Log in

Joint association of obesity and hypertension with disability in the elderly—A community-based study of residents in Shanghai, China

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Although both obesity and hypertension are known risk factors for disability, the joint association of obesity and hypertension with risk of disability is unknown. This paper is aim to examine the joint association of obesity and hypertension with risk of disability.

Methods

Cross-sectional study with 8060 elderly community-dwelling individuals participating in the survey initiated by Shanghai Health and Family Planning Commission from March to September 2013. Obesity was measured using the body mass index (BMI) in World Health Organization (WHO) Asia criteria. Hypertension, based on the doctor’s diagnosis, was obtained through face-to-face interview. Disability was measured using the self-reported physical self-maintenance scale (PSMS) and the instrumental activities of daily living (IADL) scale developed by Lawton and Brody.

Results

A total of 8.97% of participants reported ADL disability, and 15.18% for IADL disability. After adjusting social demographics and chronic conditions, the risk of ADL disability was progressively greater in obese persons with hypertension (OR=1.40, 95% CI=1.05-1.89), underweight persons without hypertension (OR=2.05, 95% CI=1.29-3.25), and underweight persons with hypertension (OR=2.14, 95% CI=1.36-3.36). For IADL disability, only underweight persons with hypertension were significantly associated (OR=1.65, 95% CI=1.23-2.21).

Conclusions

Low or extremely high BMI, independent of its metabolic consequences, is a risk factor for disability among the elderly. Simple hypertension wasn’t significantly associated with disability. In addition, having hypertension significantly increased the risk of ADL disability in obese individuals and IADL disability in underweight individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014; 384(9945): 766–81. doi: 10.1016/s0140-6736(14)60460-8

    Article  PubMed  PubMed Central  Google Scholar 

  2. Williams EP, Mesidor M, Winters K, Dubbert PM, Wyatt SB. Overweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem. Curr Obes Rep. 2015; 4(3): 363–70. doi:10.1007/s13679-015-0169-4

    Article  PubMed  Google Scholar 

  3. State Council Information Office of China. Text record of the press conference about the «China National Nutrition and Chronic Diseases Report (2015)». http://www. moh.gov.cn/xcs/s3574/201506/6b4c0f873c174ace9f57f11fd4f6f8d9.shtml. Accessed october 29 2015.

  4. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859): 2224–60. doi:10.1016/s0140-6736(12)61766-8

    Article  PubMed  PubMed Central  Google Scholar 

  5. Chen Y, Hicks A, While AE. Loneliness and social support of older people living alone in a county of Shanghai, China. Health & social care in the community. 2014; 22(4): 429–38. doi:10.1111/hsc.12099

    Article  Google Scholar 

  6. Wang YC, Colditz GA, Kuntz KM. Forecasting the obesity epidemic in the aging U.S. population. Obesity (Silver Spring). 2007; 15(11): 2855–65. doi:10.1038/oby.2007.339

    Article  PubMed  Google Scholar 

  7. Rejeski WJ, Marsh AP, Chmelo E, Rejeski JJ. Obesity, intentional weight loss and physical disability in older adults. Obes Rev. 2010; 11(9): 671–85. doi:10.1111/j.1467-789X.2009.00679.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Alley DE, Chang VW. The changing relationship of obesity and disability, 1988-2004. JAMA. 2007; 298(17): 2020–7. doi:10.1001/jama.298.17.2020

    Article  CAS  PubMed  Google Scholar 

  9. Lehtisalo J, Lindstrom J, Ngandu T, Kivipelto M, Ahtiluoto S, Ilanne-Parikka P, et al. Association of Long-Term Dietary Fat Intake, Exercise, and Weight with Later Cognitive Function in the Finnish Diabetes Prevention Study. J Nutr Health Aging. 2016; 20(2): 146–54. doi:10.1007/s12603-015-0565-1

    Article  CAS  PubMed  Google Scholar 

  10. Chuang KH, Covinsky KE, Sands LP, Fortinsky RH, Palmer RM, Landefeld CS. Diagnosis-related group-adjusted hospital costs are higher in older medical patients with lower functional status. J Am Geriatr Soc. 2003; 51(12): 1729–34. doi:10.1046/j.1532-5415.2003.51556.x

    Article  PubMed  Google Scholar 

  11. Palgi Y, Shrira A, Zaslavsky O. Quality of life attenuates age-related decline in functional status of older adults. Qual Life Res. 2015; 24(8): 1835–43. doi:10.1007/s11136-015-0918-6

    Article  PubMed  Google Scholar 

  12. Stineman MG, Xie D, Pan Q, Kurichi JE, Zhang Z, Saliba D, et al. All-cause 1-, 5-, and 10-year mortality in elderly people according to activities of daily living stage. J Am Geriatr Soc. 2012; 60(3): 485–92. doi:10.1111/j.1532-5415.2011.03867.x

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gregg EW, Guralnik JM. Is disability obesity’s price of longevity? JAMA. 2007; 298(17): 2066–7. doi:10.1001/jama.298.17.2066

    Article  CAS  PubMed  Google Scholar 

  14. Vincent HK, Vincent KR, Lamb KM. Obesity and mobility disability in the older adult. Obes Rev. 2010; 11(8): 568–79. doi:10.1111/j.1467-789X.2009.00703.x

    Article  CAS  PubMed  Google Scholar 

  15. Himes CL. Obesity, disease, and functional limitation in later life. Demography. 2000; 37(1): 73–82.

    Article  CAS  PubMed  Google Scholar 

  16. Wei L, Wu B. Racial and ethnic differences in obesity and overweight as predictors of the onset of functional impairment. J Am Geriatr Soc. 2014; 62(1): 61–70. doi:10.1111/jgs.12605

    Article  PubMed  PubMed Central  Google Scholar 

  17. Koyanagi A, Moneta MV, Garin N, Olaya B, Ayuso-Mateos JL, Chatterji S, et al. The association between obesity and severe disability among adults aged 50 or over in nine high-income, middle-income and low-income countries: a cross-sectional study. BMJ open. 2015;5(4):e007313. doi:10.1136/bmjopen-2014-007313

    Article  PubMed  PubMed Central  Google Scholar 

  18. Houston DK, Stevens J, Cai J. Abdominal fat distribution and functional limitations and disability in a biracial cohort: the Atherosclerosis Risk in Communities Study. Int J Obes (Lond). 2005; 29(12): 1457–63. doi:10.1038/sj.ijo.0803043

    Article  CAS  Google Scholar 

  19. Koster A, Patel KV, Visser M, van Eijk JT, Kanaya AM, de Rekeneire N, et al. Joint effects of adiposity and physical activity on incident mobility limitation in older adults. J Am Geriatr Soc. 2008; 56(4): 636–43. doi:10.1111/j.1532-5415.2007.01632.x

    Article  PubMed  Google Scholar 

  20. Stenholm S, Koster A, Alley DE, Houston DK, Kanaya A, Lee JS, et al. Joint association of obesity and metabolic syndrome with incident mobility limitation in older men and women—results from the Health, Aging, and Body Composition Study. J Gerontol A Biol Sci Med Sci. 2010; 65(1): 84–92. doi:10.1093/gerona/glp150

    Article  PubMed  Google Scholar 

  21. Pinhas-Hamiel O, Livne M, Harari G, Achiron A. Prevalence of overweight, obesity and metabolic syndrome components in multiple sclerosis patients with significant disability. European journal of neurology: Eur J Neurol. 2015; 22(9): 1275–9. doi:10.1111/ene.12738

    Article  CAS  PubMed  Google Scholar 

  22. Uddin MJ, Alam N, Sarma H, Chowdhury MA, Alam DS, Niessen L. Consequences of hypertension and chronic obstructive pulmonary disease, healthcare-seeking behaviors of patients, and responses of the health system: a population-based cross-sectional study in Bangladesh. BMC public health. 2014;14(1):547. doi:10.1186/1471-2458-14-547

    Article  PubMed  PubMed Central  Google Scholar 

  23. Zhang W, Ding H, Su P, Duan G, Chen R, Long J, et al. Does disability predict attempted suicide in the elderly? A community-based study of elderly residents in Shanghai, China. Aging Ment Health. 2016; 20(1): 81–7 doi:10.1080/13607863.2015.1 031641

    Article  PubMed  Google Scholar 

  24. World Health Organization. The Asia-Pacific perspective: Redefining obesity and its treatment. http://www.wpro.who.int/nutrition/documents/docs/Redefiningobesity. pdf?ua=1. Accessed December 28 2015.

  25. Lawton MP. The functional assessment of elderly people. J Am Geriatr Soc. 1971; 19(6): 465–81.

    Article  CAS  PubMed  Google Scholar 

  26. Helvik AS, Hogseth LD, Bergh S, Saltyte-Benth J, Kirkevold O, Selbaek G. A 36-month follow-up of decline in activities of daily living in individuals receiving domiciliary care. BMC Geriatr. 2015;15:47. doi:10.1186/s12877-015-0047-7

    Article  PubMed  PubMed Central  Google Scholar 

  27. Helvik AS, Engedal K, Benth JS, Selbaek G. A 52 month follow-up of functional decline in nursing home residents -degree of dementia contributes. BMC Geriatr. 2014;14:45. doi:10.1186/1471-2318-14-45

    Article  PubMed  PubMed Central  Google Scholar 

  28. Yang M, Hao Q, Luo L, Ding X, Wu H, Zhang Y, et al. Body Mass Index and Disability in Chinese Nonagenarians and Centenarians. J Am Med Dir Assoc. 2014;15(4):303.e1-.e6. doi:http://dx.doi.org/10.1016/j.jamda.2013.10.011

    Article  PubMed  Google Scholar 

  29. Al Senany S, Al Saif A. Assessment of physical health status and quality of life among Saudi older adults. J Phys Ther Sci. 2015; 27(6): 1691–5. doi:10.1589/jpts.27.1691

    Article  PubMed  PubMed Central  Google Scholar 

  30. McDermott MM, Criqui MH, Ferrucci L, Guralnik JM, Tian L, Liu K, et al. Obesity, weight change, and functional decline in peripheral arterial disease. J Vasc Surg. 2006; 43(6): 1198–204. doi:10.1016/j.jvs.2006.02.036

    Article  PubMed  PubMed Central  Google Scholar 

  31. Woo J, Leung J, Kwok T. BMI, body composition, and physical functioning in older adults. Obesity (Silver Spring). 2007; 15(7): 1886–94. doi:10.1038/oby.2007.223

    Article  PubMed  Google Scholar 

  32. Wong E, Stevenson C, Backholer K, Woodward M, Shaw JE, Peeters A. Predicting the risk of physical disability in old age using modifiable mid-life risk factors. J Epidemiol Community Health. 2015; 69(1): 70–6. doi:10.1136/jech-2014-204456

    Article  PubMed  Google Scholar 

  33. Wong E, Woodward M, Stevenson C, Backholer K, Sarink D, Peeters A. Prevalence of disability in Australian elderly: Impact of trends in obesity and diabetes. Prev Med 2016; 82: 105–10. doi:10.1016/j.ypmed.2015.11.003

    Article  PubMed  Google Scholar 

  34. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311(5): 507–20. doi:10.1001/jama.2013.284427

    Article  CAS  PubMed  Google Scholar 

  35. Szewieczek J, Dulawa J, Francuz T, Legierska K, Hornik B, Wlodarczyk-Sporek I, et al. Mildly elevated blood pressure is a marker for better health status in Polish centenarians. Age. 2015;37(1):9738. doi:10.1007/s11357-014-9738-9

    Article  PubMed  Google Scholar 

  36. Guallar-Castillon P, Sagardui-Villamor J, Banegas JR, Graciani A, Fornes NS, Lopez Garcia E, et al. Waist circumference as a predictor of disability among older adults. Obesity (Silver Spring). 2007; 15(1): 233–44. doi:10.1038/oby.2007.532

    Article  PubMed  Google Scholar 

  37. Chen H, Bermudez OI, Tucker KL. Waist circumference and weight change are associated with disability among elderly Hispanics. J Gerontol A Biol Sci Med Sci. 2002;57(1):M19–25. doi:10.1093/gerona/57.1.M19

    Article  PubMed  Google Scholar 

  38. Joung IM, van de Mheen H, Stronks K, van Poppel FW, Mackenbach JP. Differences in self-reported morbidity by marital status and by living arrangement. International journal of epidemiology. 1994; 23(1): 91–7. doi:10.1093/ije/23.1.91

    Article  CAS  PubMed  Google Scholar 

  39. McGee MA, Johnson AL, Kay DW. The description of activities of daily living in five centres in England and Wales. Medical Research Council Cognitive Function and Ageing Study. Age ageing. 1998; 27(5): 605–13. doi:10.1093/ageing/27.5.605

    CAS  PubMed  Google Scholar 

  40. Guralnik JM, La Croix AZ, Abbott RD, Berkman LF, Satterfield S, Evans DA, et al. Maintaining mobility in late life. I. Demographic characteristics and chronic conditions. Am J Epidemiol. 1993; 137(8): 845–57.

    CAS  PubMed  Google Scholar 

  41. Yang M, Ding X, Luo L, Hao Q, Dong B. Disability associated with obesity, dynapenia and dynapenic-obesity in Chinese older adults. J Am Med Dir Assoc. 2014;15(2):150.e11-6. doi:10.1016/j.jamda.2013.10.009

    Google Scholar 

  42. Jung S, Yabushita N, Kim M, Seino S, Nemoto M, Osuka Y, et al. Obesity and Muscle Weakness as Risk Factors for Mobility Limitation in Community-Dwelling Older Japanese Women: A Two-Year Follow-Up Investigation. J Nutr Health Aging. 2016; 20(1): 28–34. doi:10.1007/s12603-015-0552-6

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Health Services Management, the Second Military Medical University, No.800 Xiangyin Rd, Shanghai, 200433, China

    P. Su, W. Zhang, G. Duan, J. Long, C. Hu, Z. Sun, Z. Duan & Wenhua Tian

  2. Shanghai Medical Information Center, Shanghai, 200031, China

    H. Ding, L. Du, C. Xie & C. Jin

  3. Shanghai Health Development Research Center, Shanghai, 200040, China

    H. Ding, L. Du, C. Xie & C. Jin

  4. School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, 200433, China

    Y. Yang

  5. Shanghai Population and Development Research Center, Shanghai, 201199, China

    C. Jin

  6. Community Health Service Center, Jiangnin Street, Jing’an District, Shanghai, 200040, China

    L. Gong

Authors
  1. P. Su
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y. Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Long
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. Du
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C. Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C. Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. C. Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Z. Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Z. Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. L. Gong
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Wenhua Tian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wenhua Tian.

Additional information

Peng Su, Hansheng Ding, Wei Zhang and Guangfeng Duan contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Su, P., Ding, H., Zhang, W. et al. Joint association of obesity and hypertension with disability in the elderly—A community-based study of residents in Shanghai, China. J Nutr Health Aging 21, 362–369 (2017). https://doi.org/10.1007/s12603-016-0777-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-016-0777-z

Key words

Search

Navigation