Abstract
To assess the role of abdominal obesity in the incidence of disability in older adults living in São Paulo, Brazil, in a 5-year period. Longitudinal study, part of the SABE Study (Health, Wellbeing and Aging). We assessed the disability incidence in the period (reported difficulty in at least one activity of daily living (ADL) in 2010) in relation to abdominal obesity in 2006 (waist circumference ≥102 cm in men and ≥88 cm in women). We used Poisson regression to evaluate the association between obesity and disability incidence, adjusting for sociodemographic and clinical factors including BMI. São Paulo, Brazil. Older adults (n 1109) who were independent in ADL in 2006. In 2010, 789 of these were located and re-interviewed. The crude disability incidence (at least one ADL) was 27·1/1000 person-years in the period. The incidence rate was two times higher in participants with abdominal obesity compared with those without (39·1/1000 and 19·4/1000 person-years, respectively; P<0·001). This pattern was observed in all BMI levels. In regression models, abdominal obesity remained associated with disability incidence (incidence rate ratio=1·90; P<0·03), even after controlling for BMI, gender, age, low grip strength, cognitive impairment, physical inactivity and chronic diseases. Abdominal obesity was strong risk factor for disability, showing a more significant effect than BMI, and thus should be an intervention target for older adults. Waist measure is simple, cost-effective and easily interpreted, and therefore can be used in several settings to identify individuals at higher risk of disability.
Highlights
MethodsSample and procedures The data came from the SABE Study (Health, Wellbeing and Aging), which is a longitudinal study that began in 2000 and involved a multiple-stage probabilistic sample of individuals (aged 60 years or above) who live in São Paulo (n 2143)
Nutritional and physical statuses at baseline were different between groups: those who had incident disability had higher BMI and waist circumference (WC), lower hand grip strength, and higher proportions of obesity and abdominal obesity
When both variables were in the same model, controlled for the other significant factors presented in the descriptive analysis, abdominal obesity was still significant, presenting a risk 1·90 higher than for those without abdominal obesity (P < 0·03), and general overweight/obesity represented by BMI was no longer significant
Summary
Sample and procedures The data came from the SABE Study (Health, Wellbeing and Aging), which is a longitudinal study that began in 2000 and involved a multiple-stage probabilistic sample of individuals (aged 60 years or above) who live in São Paulo (n 2143). Nutritional status was classified based on BMI cut-off points adopted by the Pan American Health Organization for the SABE Study[36]: ≤23·0 kg/m2 = underweight; >23·0 and
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