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The Association Between BMI and Different Frailty Domains: A U-Shaped Curve?

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The journal of nutrition, health & aging

Abstract

Objectives

Previous studies showed a U-shaped association between BMI and (physical) frailty. We studied the association between BMI and physical, cognitive, psychological, and social frailty. Furthermore, the overlap between and prevalence of these frailty domains was examined.

Design

Cross-sectional study.

Setting

The Doetinchem Cohort Study is a longitudinal population-based study starting in 1987-1991 examining men and women aged 20-59 with follow-up examinations every 5 yrs.

Participants

For the current analyses, we used data from round 5 (2008-2012) with 4019 participants aged 41-81 yrs.

Measurements

Physical frailty was defined as having ≥ 2 of 4 frailty criteria from the Frailty Phenotype (unintentional weight loss, exhaustion, physical activity, handgrip strength). Cognitive frailty was defined as the < 10th percentile on global cognitive functioning (based on memory, speed, flexibility). Psychological frailty was defined as having 2 out of 2 criteria (depression, mental health). Social frailty was defined as having ≥ 2 of 3 criteria (loneliness, social support, social participation). BMI was divided into four classes. Analyses were adjusted for sex, age, level of education, and smoking.

Results

A U-shaped association was observed between BMI and physical frailty, a small linear association for BMI and cognitive frailty and no association between BMI and psychological and social frailty. The four frailty domains showed only a small proportion of overlap. The prevalence of physical, cognitive and social frailty increased with age, whereas psychological frailty did not.

Conclusion

We confirm that not only underweight but also obesity is associated with physical frailty. Obesity also seems to be associated with cognitive frailty. Further, frailty prevention should focus on multiple domains and target individuals at a younger age (<65yrs).

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Authors and Affiliations

  1. National Institute for Public Health and the Environment, Bilthoven, the Netherlands

    M. Liset Rietman, D. L. van der A, S. H. van Oostrom, H. S. J. Picavet, M. E. T. Dollé, H. van Steeg, W. M. M. Verschuren & A. M. W. Spijkerman

  2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands

    M. Liset Rietman & W. M. M. Verschuren

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  1. M. Liset Rietman
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  2. D. L. van der A
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  3. S. H. van Oostrom
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  4. H. S. J. Picavet
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  8. A. M. W. Spijkerman
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Correspondence to M. Liset Rietman.

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Rietman, M.L., van der A, D.L., van Oostrom, S.H. et al. The Association Between BMI and Different Frailty Domains: A U-Shaped Curve?. J Nutr Health Aging 22, 8–15 (2018). https://doi.org/10.1007/s12603-016-0854-3

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  • DOI: https://doi.org/10.1007/s12603-016-0854-3

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