Dynapenia in middle-aged and older persons with and without abdominal obesity and the complex relationship with behavioral, physical-health and mental-health variables: Learning Bayesian network structures.

Abstract

Few studies have analyzed the relationship between dynapenia and lifestyle, physical-health and mental-health variables in middle-aged and older persons classified according to their waist circumference. The aim of this study was to identify the relationships between dynapenia and behavioral, physical-health and mental-health variables in middle-aged and older persons with and without abdominal obesity using Bayesian networks, a graphical analysis technique that allows simultaneous associations between variables to be identified. A cross-sectional study of 2526 participants without abdominal obesity and 2729 with abdominal obesity (waist circumference>102cm in men and >88cm in women) aged 50 years or older who took part in the Brazilian Longitudinal Study of Aging. Two network structures including behavioral, physical-health and mental-health variables and dynapenia (grip strength<26kg for men and <16kg for women) were learnt with the hill-climbing score-based algorithm for a sample of individuals with and without abdominal obesity. Statistical resampling tests were performed to quantify the strength of the relationships between factors associated with dynapenia. In middle-aged and older persons without abdominal obesity, dynapenia was strongly associated with and influenced by at-risk alcohol consumption while in middle-aged and older persons with abdominal obesity the condition was strongly associated with and influenced by diabetes and depression. In the latter group, dynapenia was also strongly associated with and influenced the disability. The use of Bayesian networks allowed different factors associated with dynapenia in middle-aged and older persons classified according to the presence or absence of abdominal obesity to be identified.