The journal of nutrition, health & aging

, Volume 22, Issue 10, pp 1228–1237 | Cite as

Abdominal Obesity and Mobility Disability in Older Adults: A 4-Year Follow-Up of the International Mobility in Aging Study

  • Juliana Fernandes de Souza BarbosaEmail author
  • C. dos Santos Gomes
  • J. Vilton Costa
  • T. Ahmed
  • M. V. Zunzunegui
  • C.-L. Curcio
  • F. Gomez
  • R. Oliveira Guerra



Abdominal obesity is related to the disability process in older adults, however, little is known about this relationship when adjusted for important confounders such as depression and physical performance measures in a diverse international aged population.


To explore the longitudinal relationship between abdominal obesity and mobility disability controlling for physical performance and depression.

Design and Setting

Longitudinal observational study using data from the International Mobility in Aging Study (IMIAS) Study.


1104 out of 2002 older adults aged 64–74 years old free of mobility disability at baseline (2012) and then reassessed in 2016.


Mobility disability was defined as reporting difficulty in walking 400 m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. Abdominal obesity was defined as waist circumference ≥ 88cm for women or ≥ 102 cm for men. Four meters gait speed, handgrip strength and depressive symptoms (CES-D) were assessed. Generalized Estimating Equations (GEE) and multinomial regressions were used to estimate associations between disability and abdominal obesity.


1104 free of disability participants were followed over 4 years, the mean age was 68.9 (±2.9) years among men and 68.7 (±2.6) years among women. Prevalence and incidence rates of mobility disability varied widely across research site and sex. The longitudinal associations between mobility disability and abdominal obesity remained significant even when adjusted by depressive symptoms, handgrip strength, gait speed, age, sex, education and research site. Participants with abdominal obesity had higher mobility disability (OR=1.68, 95% CI 1.23-1.76, p-value=0.01) and also increased risk for ADL disability (OR: 1.47, 95% CI 1.23-1.76, p-value=0.01). Abdominal obesity in baseline was also predictor of mobility disability in 2016 (OR: 1.93, 95% CI 1.17-3.17, p-value <0.01) but not for ADL disability (OR: 1.59, 95% CI 0.93-2.71, p-value =0.09) with accounting mortality.


Abdominal obesity is associated longitudinally and predicts mobility disability, even over a short period (4 years) in community-dwelling older adults from different epidemiological contexts.

Key words

Disability mobility activities of Daily Living abdominal obesity aging 


  1. 1.
    World Health Organization., World Bank. World Report on Disability 2011. World Health OrganizationGoogle Scholar
  2. 2.
    Manini T. Development of physical disability in older adults. Curr Aging Sci 2011;4:184–91. doi: 10.2174/1874609811104030184CrossRefGoogle Scholar
  3. 3.
    Chen CMC-M, Mullan J, Su YYY-Y, et al. The Longitudinal Relationship Between Depressive Symptoms and Disability for Older Adults: A Population-Based Study. Journals Gerontol-Ser A Biol Sci Med Sci 2012;67:1059–1067. doi: 10.1093/gerona/gls074CrossRefGoogle Scholar
  4. 4.
    Cronin-Stubbs D, de Leon CF, Beckett L a, et al. Six-year effect of depressive symptoms on the course of physical disability in community-living older adults. Arch Intern Med 2000;160:3074–80. doi: 10.1001/archinte.160.20.3074CrossRefGoogle Scholar
  5. 5.
    Lenze EJ, Schulz R, Martire LM, et al. The Course of Functional Decline in Older People with Persistently Elevated Depressive Symptoms: Longitudinal Findings from the Cardiovascular Health Study. J Am Geriatr Soc 2005;53:569–575. doi: 10.1111/j.1532-5415.2005.53202.xCrossRefGoogle Scholar
  6. 6.
    Van Gool CH, Kempen GIJM, Penninx BWJH, et al. Impact of depression on disablement in late middle aged and older persons: Results from the Longitudinal Aging Study Amsterdam. Soc Sci Med 2005;60:25–36. doi: 10.1016/j.socscimed.2004.04.021CrossRefGoogle Scholar
  7. 7.
    Legrand D, Vaes B, Matheï C, et al. Muscle strength and physical performance as predictors of mortality, hospitalization, and disability in the oldest old. J Am Geriatr Soc 2014;62:1030–8. doi: 10.1111/jgs.12840CrossRefGoogle Scholar
  8. 8.
    Cesari M, Rolland Y, Abellan Van Kan G, et al. Sarcopenia-related parameters and incident disability in older persons: results from the “invecchiare in Chianti” study. J Gerontol A Biol Sci Med Sci 2014;70:457–63. doi: 10.1093/gerona/glu181CrossRefGoogle Scholar
  9. 9.
    Samper-Ternent R, Al Snih S. Obesity in Older Adults: Epidemiology and Implications for Disability and Disease. Rev Clin Gerontol 2012;22:10–34. doi: 10.1017/S0959259811000190CrossRefGoogle Scholar
  10. 10.
    Vincent HK, Vincent KR, Lamb KM. Obesity and mobility disability in the older adult. Obes Rev 2010;11:568–579. doi: 10.1111/j.1467-789X.2009.00703.xCrossRefGoogle Scholar
  11. 11.
    Harris TB, Visser M, Everhart J, et al. Waist circumference and sagittal diameter reflect total body fat better than visceral fat in older men and women. The Health, Aging and Body Composition Study. Ann N Y Acad Sci 2000;904:462–73. doi: 10.1111/j.1749-6632.2000.tb06501.xCrossRefGoogle Scholar
  12. 12.
    Angleman SB, Harris TB, Melzer D. The role of waist circumference in predicting disability in periretirement age adults. Int J Obes 2006;30:364–373. doi: 10.1038/ sj.ijo.0803130CrossRefGoogle Scholar
  13. 13.
    Guallar-Castillon P, Sagardui-Villamor J, JR B, et al. Waist circumference as a predictor of disability among older adults. Obesity 2007;15:233–244CrossRefGoogle Scholar
  14. 14.
    Pires Corona L, Da T, Alexandre S, et al. Abdominal obesity as a risk factor for disability in Brazilian older adults. Public Health Nutr 2017;20:1046–1053. doi: 10.1017/S1368980016003505CrossRefGoogle Scholar
  15. 15.
    Hamer M, Batty GD, Kivimaki M. Sarcopenic obesity and risk of new onset depressive symptoms in older adults: English Longitudinal Study of Ageing. Int J Obes (Lond) 2015;39:1717–20. doi: 10.1038/ijo.2015.124CrossRefGoogle Scholar
  16. 16.
    Marijnissen RM, Vogelzangs N, Mulder ME, et al. Metabolic dysregulation and latelife depression: a prospective study. Psychol Med 2017;47:1041–1052. doi: 10.1017/ S0033291716003196CrossRefGoogle Scholar
  17. 17.
    Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, Obesity, and Depression. Arch Gen Psychiatry 2010;67:220. doi: 10.1001/archgenpsychiatry.2010.2CrossRefGoogle Scholar
  18. 18.
    Xiang X, An R. Obesity and onset of depression among U.S. middle-aged and older adults. J Psychosom Res 2015;78:242–248. doi: 10.1016/j.jpsychores.2014.12.008Google Scholar
  19. 19.
    Murphy RA, Reinders I, Register TC, et al. Associations of BMI and adipose tissue area and density with incident mobility limitation and poor performance in older adults. Am J Clin Nutr 2014;99:1059–65. doi: 10.3945/ajcn.113.080796CrossRefGoogle Scholar
  20. 20.
    Keevil VL, Luben R, Dalzell N, et al (2015) Cross-Sectional Associations between Different Measures of Obesity and Muscle Strength in Men and Women in a British Cohort Study. J Nutr Health Aging 2015;19:3–11. doi: 10.1007/s12603-014-0492-6CrossRefGoogle Scholar
  21. 21.
    Vermeulen J, Neyens JCLJ, van Rossum E, et al (2011) Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review. BMC Geriatr 2011;11:33. doi: 10.1186/1471-2318-11-33CrossRefGoogle Scholar
  22. 22.
    Bianchi L, Ferrucci L, Cherubini A, et al (2015) The Predictive Value of the EWGSOP Definition of Sarcopenia: Results From the InCHIANTI Study. J Gerontol A Biol Sci Med Sci 2015;71:glv129-. doi: 10.1093/gerona/glv129Google Scholar
  23. 23.
    Alexandre T da S, Scholes S, Ferreira Santos JL, et al. The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults. Clin Nutr 2017;:. doi: 10.1016/j.clnu.2017.09.018Google Scholar
  24. 24.
    Abellan van Kan G, Rolland Y, Andrieu S, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging 2009;13:881–9. doi: 10.1007/s12603-009-0246-zCrossRefGoogle Scholar
  25. 25.
    Gomez F, Zunzunegui MV, Alvarado B, et al. Cohort Profile: The International Mobility In Aging Study (IMIAS). Int J Epidemiol, 2018. doi: 10.1093/ije/dyy074Google Scholar
  26. 26.
    Zunzunegui MV V, Alvarado BEE, Guerra R, et al. The mobility gap between older men and women: The embodiment of gender. Arch Gerontol Geriatr 2015;61:140–148. doi: 10.1016/j.archger.2015.06.005CrossRefGoogle Scholar
  27. 27.
    Caldas VV de A, Zunzunegui MV, Freire A do NF, Guerra RO. Translation, cultural adaptation and psychometric evaluation of the Leganés cognitive test in a low educated elderly Brazilian population. Arq Neuropsiquiatr 2012;70:22–7CrossRefGoogle Scholar
  28. 28.
    Guralnik JM, Ferrucci L, Simonsick EM, et al. Lower-Extremity Function in Persons over the Age of 70 Years as a Predictor of Subsequent Disability. N Engl J Med 1995;332:556–562. doi: 10.1056/NEJM199503023320902CrossRefGoogle Scholar
  29. 29.
    Nagi SZ. An Epidemiology of Disability among Adults in the United States. 1976;54:439–467Google Scholar
  30. 30.
    Freire a. N, Guerra RO, Alvarado B, et al. Validity and Reliability of the Short Physical Performance Battery in Two Diverse Older Adult Populations in Quebec and Brazil. J Aging Health 2012;24:863–878. doi: 10.1177/0898264312438551CrossRefGoogle Scholar
  31. 31.
    Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000;55:M221–31CrossRefGoogle Scholar
  32. 32.
    Guralnik JM, Ferrucci L, Simonsick EM, et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995;332:556–61. doi: 10.1056/NEJM199503023320902CrossRefGoogle Scholar
  33. 33.
    World Health Organization (2000) WHO | Obesity: preventing and managing the global epidemic. World Health OrganizationGoogle Scholar
  34. 34.
    National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and T of HBC in A (Adult TPI. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143–421Google Scholar
  35. 35.
    Fess E. Grip Strength, 2nd ed. American Society of Hand Therapists, Chicago 1992Google Scholar
  36. 36.
    Ylli A, Miszkurka M, Phillips SP, et al. Clinically relevant depression in old age: An international study with populations from Canada, Latin America and Eastern Europe. Psychiatry Res 2016;241:236–241. doi: 10.1016/j.psychres.2016.04.096CrossRefGoogle Scholar
  37. 37.
    Bento JA, Lebrão ML. Suficiência de renda percebida por pessoas idosas no Município de São Paulo/Brasil. Cien Saude Colet 2013;18:2229–2238. doi: 10.1590/ S1413-81232013000800007CrossRefGoogle Scholar
  38. 38.
    Guralnik JM. Assessing the impact of comorbidity in the older population. Ann Epidemiol 1996;6:376–80CrossRefGoogle Scholar
  39. 39.
    Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. Association of comorbidity with disability in older women: the Women’s Health and Aging Study. J Clin Epidemiol 1999;52:27–37CrossRefGoogle Scholar
  40. 40.
    Marsh AP, Janssen JA, Ip EH, et al. Assessing Walking Activity in Older Adults: Development and Validation of a Novel Computer-Animated Assessment Tool. Journals Gerontol Ser A Biol Sci Med Sci 2015;70:1555–1561. doi: 10.1093/gerona/ glv101CrossRefGoogle Scholar
  41. 41.
    Drumond Andrade FC, Guevara PE, Lebrão ML, et al. Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in S??o Paulo, Brazil. Women’s Heal Issues 2011;21:64–70. doi: 10.1016/j.whi.2010.08.007CrossRefGoogle Scholar
  42. 42.
    Koster A, Patel K V., Visser M, et al. Joint Effects of Adiposity and Physical Activity on Incident Mobility Limitation in Older Adults. J Am Geriatr Soc 2008;56:636–643. doi: 10.1111/j.1532-5415.2007.01632.xCrossRefGoogle Scholar
  43. 43.
    Guallar-Castillón P, Sagardui-Villamor J, Banegas JRJR, et al. Waist circumference as a predictor of disability among older adults. Obesity 2007;15:233–244. doi: 10.1038/ oby.2007.532CrossRefGoogle Scholar
  44. 44.
    Naugle KM, Higgins TJ, Manini TM. Obesity and use of compensatory strategies to perform common daily activities in pre-clinically disabled older adults. Arch Gerontol Geriatr 2012;54:e134–e138. doi: 10.1016/j.archger.2011.10.017CrossRefGoogle Scholar
  45. 45.
    Yerrakalva D, Mullis R, Mant J. The associations of fatness, fitness, and physical activity with all-cause mortality in older adults: A systematic review. Obesity 2015;23:1944–1956CrossRefGoogle Scholar
  46. 46.
    Na YM, Park HA, Kang JH, et al. Obesity, obesity related disease, and disability. Korean J Fam Med 2011;32:412–22. doi: 10.4082/kjfm.2011.32.7.412CrossRefGoogle Scholar
  47. 47.
    Schrager MA, Metter EJ, Simonsick E, et al. Sarcopenic obesity and inflammation in the InCHIANTI study. J Appl Physiol 2007;102:919–25. doi: 10.1152/ japplphysiol.00627.2006CrossRefGoogle Scholar
  48. 48.
    Angel RJ, Angel JL, Hill TD. Longer lives, sicker lives? Increased longevity and extended disability among Mexican-origin elders. Journals Gerontol -Ser B Psychol Sci Soc Sci 2015;70:639–649. doi: 10.1093/geronb/gbu158CrossRefGoogle Scholar
  49. 49.
    Hill TD, Burdette AM, Taylor J, Angel JL. Religious Attendance and the Mobility Trajectories of Older Mexican Americans. J Health Soc Behav 2016;57:118–134. doi: 10.1177/0022146515627850CrossRefGoogle Scholar
  50. 50.
    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. doi: 10.1093/epirev/mxs006CrossRefGoogle Scholar
  51. 51.
    Perera S, Patel K V, Rosano C, et al. Gait Speed Predicts Incident Disability: A Pooled Analysis. J Gerontol A Biol Sci Med Sci 2016;71:63–71. doi: 10.1093/gerona/glv126CrossRefGoogle Scholar
  52. 52.
    Abellan Van Kan G, Rolland Y, Andrieu S, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging 2009;13:881–889. doi: 10.1007/s12603-009-0246-zCrossRefGoogle Scholar
  53. 53.
    Batsis JA, Mackenzie TA, Bartels SJ, et al. Diagnostic accuracy of body mass index to identify obesity in older adults: NHANES 1999–2004. Int J Obes (Lond) 2016;40:761–7. doi: 10.1038/ijo.2015.243CrossRefGoogle Scholar
  54. 54.
    Spencer SM, Albert SM, Bear-Lehman J, Burkhardt A. Relevance of race and ethnicity for self-reported functional limitation. J Am Geriatr Soc 2008;56:553–7. doi: 10.1111/j.1532-5415.2007.01595.xCrossRefGoogle Scholar
  55. 55.
    Crawford SL, Jette AM, Tennstedt SL. Test-retest reliability of self-reported disability measures in older adults. J Am Geriatr Soc 1997;45:338–41CrossRefGoogle Scholar
  56. 56.
    Misra A, Wasir JS, Vikram NK. Waist circumference criteria for the diagnosis of abdominal obesity are not applicable uniformly to all populations and ethnic groups. Nutrition 2005;21:969–976. doi: 10.1016/j.nut.2005.01.007CrossRefGoogle Scholar
  57. 57.
    Chateau-Degat ML, Dewailly E, Poirier P, et al. Comparison of diagnostic criteria of the metabolic syndrome in 3 ethnic groups of Canada. Metabolism 2008;57:1526–1532. doi: 10.1016/j.metabol.2008.06.006CrossRefGoogle Scholar
  58. 58.
    Ujcic-Voortman JK, Bos G, Baan CA, et al. Obesity and body fat distribution: Ethnic differences and the role of socio-economic status. Obes Facts 2011;4:53–60. doi: 10.1159/000324555CrossRefGoogle Scholar
  59. 59.
    Bannerman E, Miller MD, Daniels LA, et al. Anthropometric indices predict physical function and mobility in older Australians: the Australian Longitudinal Study of Ageing. 2017;doi: 10.1079/PHN2002336Google Scholar
  60. 60.
    Nam S, Kuo Y-F, Markides KS, et al. Waist circumference (WC), body mass index (BMI), and disability among older adults in Latin American and the Caribbean (LAC). Arch Gerontol Geriatr 2012;55:e40–e47. doi: 10.1016/j.archger.2012.04.006CrossRefGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Juliana Fernandes de Souza Barbosa
    • 1
    Email author
  • C. dos Santos Gomes
    • 1
  • J. Vilton Costa
    • 2
  • T. Ahmed
    • 3
  • M. V. Zunzunegui
    • 4
  • C.-L. Curcio
    • 5
  • F. Gomez
    • 5
  • R. Oliveira Guerra
    • 1
  1. 1.Department of PhysiotherapyFederal University of Rio Grande do NorteNatal/RNBrazil
  2. 2.Department of Demography and Actuarial SciencesFederal University of Rio Grande do NorteNatalBrazil
  3. 3.University of Montreal Hospital Research Centre, University of MontrealMontrealCanada
  4. 4.Research Institute of Public HealthUniversity of MontrealMontrealCanada
  5. 5.Faculty of Health SciencesUniversidad de CaldasManizalesColombia

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