A novel functional fitness score and its association with obesity status in non-institutionalized males and females aged 65 or over: The exernet multicenter study
AbstractIntroduction: Performing activities of daily living independently and safely requires adequate levels of strength, endurance and agility. However, functional fitness (FF) components have been usually evaluated separately. We aimed to create a novel global FF score and to calculate its relationship with adiposity levels in the elderly. Methods: Muscle mass, body fat and waist circumference were obtained in 3,136 non-institutionalized Spanish elderly subjects. Physical performance was evaluated by the Senior Fitness Test battery (upper- and lower-body strength, agility and endurance). The participants were categorized as highly fit (HF; moderate-high functioning in all FF capacities), moderately fit (MF; low-functioning in 1-3 FF measures) and unfit (UF; low-functioning in all FF capacities) according to the FF score. Odds ratios for obesity, central obesity and sarcopenic obesity were calculated according to the FF score. Results: The percentage of UF older adults was 6.9%. Agility was the most impaired physical condition among all the participants. A lower FF score was significantly related with a higher prevalence of obesity, central obesity and sarcopenic obesity. Conclusion: A strong relationship between lower levels of FF and higher levels of adiposity was observed. In order to provide a greater independence in later life we should emphasize about the need for concerted efforts to prevent and treat the FF decline with aging.
Batsis, J. A., Barre, L. K., Mackenzie, T. A., Pratt, S. I., Lopez-Jimenez, F., & Bartels, S. J. (2013). Variation in the prevalence of sarcopenia and sarcopenic obesity in older adults associated with different research definitions: Dual-energy X-ray absorptiometry data from the National Health and Nutrition Examination Survey 1999-2004. Journal of the American Geriatrics Society, 61(6), 974-980.
Baumgartner, R. N. (2000) Body composition in healthy aging. Vol. 904. Annals of the New York Academy of Sciences (pp. 437-448).
Baumgartner, R. N., Wayne, S. J., Waters, D. L., Janssen, I., Gallagher, D., & Morley, J. E. (2004). Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly. Obesity Research, 12(12), 1995-2004.
Bouchard, D. R., Dionne, I. J., & Brochu, M. (2009). Sarcopenic/obesity and physical capacity in older men and women: Data from the nutrition as a determinant of successful aging (nuage)the quebec longitudinal study. Obesity, 17(11), 2082-2088.
Coakley, E. H., Kawachi, I., Manson, J. E., Speizer, F. E., Willet, W. C., & Colditz, G. A. (1998). Lower levels of physical functioning are associated with higher body weight among middle-aged and older women. International Journal of Obesity, 22(10), 958-965.
Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., . . . Zamboni, M. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing, 39(4), 412-423. doi: 10.1093/ageing/afq034
Davison, K. K., Ford, E. S., Cogswell, M. E., & Dietz, W. H. (2002). Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III. Journal of the American Geriatrics Society, 50(11), 1802-1809.
Donath, L., van Dieen, J., & Faude, O. (2016). Exercise-Based Fall Prevention in the Elderly: What About Agility? Sports Med, 46(2), 143-149. doi: 10.1007/s40279-015-0389-5
Fiatarone Singh, M. A. (2002). Exercise to prevent and treat functional disability. Clinics in Geriatric Medicine, 18(3), 431-462.
Fried, L. P., Tangen, C. M., Walston, J., Newman, A. B., Hirsch, C., Gottdiener, J., . . . McBurnie, M. A. (2001). Frailty in older adults: Evidence for a phenotype. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 56(3), M146-M156.
Gallagher, D., Heymsfield, S. B., Heo, M., Jebb, S. A., Murgatroyd, P. R., & Sakamoto, Y. (2000). Healthy percentage body fat ranges: An approach for developing guidelines based on body mass index. American Journal of Clinical Nutrition, 72(3), 694-701.
Garcia-Garcia, F. J., Gutierrez Avila, G., Alfaro-Acha, A., Amor Andres, M. S., De Los Angeles De La Torre Lanza, M., Escribano Aparicio, M. V., . . . Rodriguez-Manas, L. (2011). The prevalence of frailty syndrome in an older population from Spain. The Toledo Study for Healthy Aging. J Nutr Health Aging, 15(10), 852-856.
Gomez-Cabello, A., Pedrero-Chamizo, R., Olivares, P. R., Luzardo, L., Juez-Bengoechea, A., Mata, E., . . . Ara, I. (2011). Prevalence of overweight and obesity in non-institutionalized people aged 65 or over from Spain: The elderly EXERNET multi-centre study. Obesity Reviews, 12(8), 583-592.
Gómez-Cabello, A., Vicente-Rodríguez, G., Albers, U., Mata, E., Rodriguez-Marroyo, J. A., Olivares, P. R., . . . Ara, I. (2012). Harmonization process and reliability assessment of anthropometric measurements in the elderly exernet multi-centre study. PLoS ONE, 7(7).
Gouveia, É. R., Maia, J. A., Beunen, G. P., Blimkie, C. J., Fena, E. M., & Freitas, D. L. (2013). Functional fitness and physical activity of portuguese community-residing older adults. Journal of Aging and Physical Activity, 21(1), 1-19.
Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332(9), 556-561.
Gusi, N., Prieto, J., Olivares, P. R., Delgado, S., Quesada, F., & Cebrián, C. (2012). Normative fitness performance scores of community-dwelling older adults in Spain. Journal of Aging and Physical Activity, 20(1), 106-126.
Harper, S. (2014). Economic and social implications of aging societies. Science, 346(6209), 587-591.
Huang, Y., Macera, C. A., Blair, S. N., Brill, P. A., Kohl Iii, H. W., & Kronenfeld, J. J. (1998). Physical fitness, physical activity, and functional limitation in adults aged 40 and older. Medicine and Science in Sports and Exercise, 30(9), 1430-1435.
Hughes, V. A., Frontera, W. R., Wood, M., Evans, W. J., Dallal, G. E., Roubenoff, R., & Fiatarone Singh, M. A. (2001). Longitudinal muscle strength changes in older adults: influence of muscle mass, physical activity, and health. J Gerontol A Biol Sci Med Sci, 56(5), B209-217.
Janssen, I., Heymsfield, S. B., Baumgartner, R. N., & Ross, R. (2000). Estimation of skeletal muscle mass by bioelectrical impedance analysis. Journal of Applied Physiology, 89(2), 465-471.
Konopack, J. F., Marquez, D. X., Hu, L., Elavsky, S., McAuley, E., & Kramer, A. F. (2008). Correlates of functional fitness in older adults. International Journal of Behavioral Medicine, 15(4), 311-318.
Koster, A., Patel, K. V., Visser, M., Van Eijk, J. T. M., Kanaya, A. M., De Rekeneire, N., . . . Harris, T. B. (2008). Joint effects of adiposity and physical activity on incident mobility limitation in older adults. Journal of the American Geriatrics Society, 56(4), 636-643.
Krause, M. P., Januário, R. S. B., Hallage, T., Haile, L., Miculis, C. P., Gama, M. P. R., . . . Da Silva, S. G. (2009). A comparison of functional fitness of older Brazilian and American women. Journal of Aging and Physical Activity, 17(4), 387-397.
Król-Zielińska, M., Kusy, K., Zieliński, J., & Osiński, W. (2011). Physical activity and functional fitness in institutionalized vs. independently living elderly: A comparison of 70-80-year-old city-dwellers. Archives of Gerontology and Geriatrics, 53(1), e10-e16.
Langhammer, B., & Stanghelle, J. K. (2011). Functional fitness in elderly Norwegians measured with the Senior Fitness Test. Advances in Physiotherapy, 13(4), 137-144.
Lean, M. E., Han, T. S., & Morrison, C. E. (1995). Waist circumference as a measure for indicating need for weight management. British Medical Journal, 311(6998), 158-161.
Lobo, A. (2012). Relationship between physical condition, functional fitness, and falls risk in elderly adults. Journal of the American Geriatrics Society, 60(9), 1788-1789.
Lutz, W., Sanderson, W., & Scherbov, S. (2008). The coming acceleration of global population ageing. Nature, 451(7179), 716-719. doi: 10.1038/nature06516
Lynch, N. A., Metter, E. J., Lindle, R. S., Fozard, J. L., Tobin, J. D., Roy, T. A., . . . Hurley, B. F. (1999). Muscle quality. I. Age-associated differences between arm and leg muscle groups. J Appl Physiol (1985), 86(1), 188-194.
Marques, E. A., Baptista, F., Santos, R., Vale, S., Santos, D. A., Silva, A. M., . . . Sardinha, L. B. (2014). Normative functional fitness standards and trends of portuguese older adults: Cross-cultural comparisons. Journal of Aging and Physical Activity, 22(1), 126-137.
Paterson, D. H., Jones, G. R., & Rice, C. L. (2007). Ageing and physical activity: Evidence to develop exercise recommendations for older adults. Applied Physiology, Nutrition and Metabolism, 32(SUPPL. 2E), S69-S108.
Pedrero-Chamizo, R., Gómez-Cabello, A., Delgado, S., Rodríguez-Llarena, S., Rodríguez-Marroyo, J. A., Cabanillas, E., . . . Pulido, P. (2012). Physical fitness levels among independent non-institutionalized Spanish elderly: The elderly EXERNET multi-center study. Archives of Gerontology and Geriatrics, 55(2), 406-416.
Pedrero-Chamizo, R., Gomez-Cabello, A., Melendez, A., Vila-Maldonado, S., Espino, L., Gusi, N., . . . Ara, I. (2015). Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among the elderly: the EXERNET multi-center study. J Nutr Health Aging, 19(2), 211-217. doi: 10.1007/s12603-014-0530-4
Riebe, D., Blissmer, B. J., Greaney, M. L., Ewing Garber, C., Lees, F. D., & Clark, P. G. (2009). The relationship between obesity, physical activity, and physical function in older adults. Journal of Aging and Health, 21(8), 1159-1178.
Rikli, R. E., & Jones, C. J. (1998). The reliability and validity of a 6-minute walk test as a measure of physical endurance in older adults. Journal of Aging and Physical Activity, 6(4), 363-375.
Rikli, R. E., & Jones, C. J. (1999a). Development and validation of a functional fitness test for community- residing older adults. Journal of Aging and Physical Activity, 7(2), 129-161.
Rikli, R. E., & Jones, C. J. (1999b). Functional fitness normative scores for community-residing older adults, ages 60-94. Journal of Aging and Physical Activity, 7(2), 162-181.
Rikli, R. E., & Jones, C. J. (2001). Senior fitness test manual (1 ed.). Champaign, Illinois: Human kinetics.
Rikli, R. E., & Jones, C. J. (2013). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist, 53(2), 255-267.
Sanchez-Garcia, S., Garcia-Pena, C., Duque-Lopez, M. X., Juarez-Cedillo, T., Cortes-Nunez, A. R., & Reyes-Beaman, S. (2007). Anthropometric measures and nutritional status in a healthy elderly population. BMC Public Health, 7, 2. doi: 10.1186/1471-2458-7-2
Santos-Eggimann, B., Cuénoud, P., Spagnoli, J., & Junod, J. (2009). Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 64(6), 675-681.
Santos, D. A., Silva, A. M., Baptista, F., Santos, R., Vale, S., Mota, J., & Sardinha, L. B. (2012). Sedentary behavior and physical activity are independently related to functional fitness in older adults. Experimental Gerontology, 47(12), 908-912.
Scott, D., Sanders, K. M., Aitken, D., Hayes, A., Ebeling, P. R., & Jones, G. (2014). Sarcopenic obesity and dynapenic obesity: 5-year associations with falls risk in middle-aged and older adults. Obesity, 22(6), 1568-1574.
So, W. Y., Song, M., Park, Y. H., Cho, B. L., Lim, J. Y., Kim, S. H., & Song, W. (2013). Body composition, fitness level, anabolic hormones, and inflammatory cytokines in the elderly: A randomized controlled trial. Aging Clinical and Experimental Research, 25(2), 167-174.
Tainaka, K., Takizawa, T., Katamoto, S., & Aoki, J. (2009). Six-year prospective study of physical fitness and incidence of disability among community-dwelling Japanese elderly women. Geriatrics and Gerontology International, 9(1), 21-28.
Visser, M., Goodpaster, B. H., Kritchevsky, S. B., Newman, A. B., Nevitt, M., Rubin, S. M., . . . Harris, T. B. (2005). Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 60(3), 324-333.
WHO. (1995). Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organization technical report series, 854, 1-452.
Wilkin, L. D., & Haddock, B. L. (2011). Functional fitness of older adults. Activities, Adaptation and Aging, 35(3), 197-209.
Woo, J., Leung, J., & Kwok, T. (2007). BMI, body composition, and physical functioning in older adults. Obesity, 15(7), 1886-1894.
Zoico, E., Di Francesco, V., Guralnik, J. M., Mazzali, G., Bortolani, A., Guariento, S., . . . Zamboni, M. (2004). Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. International Journal of Obesity, 28(2), 234-241.