Abstract
As life expectancy and obesity increase in low and middle-income countries, the relationship of weight status to functional outcomes in older adults in these settings requires attention. We examined how overweight (BMI > 25 kg/m2), obesity (BMI > 30 kg/m2), and high waist circumference (WC > 80 cm) related to grip strength, timed up-and-go, and development of limitations in mobility, activities of daily living (ADL), and instrumental activities of daily living (IADL) among Filipino women. We analyzed data from seven rounds of the Cebu Longitudinal Health and Nutrition Survey (1994, n = 2279 to 2015, n = 1568, age 49–78 years) to examine how women’s reports of functional limitations related to their prior WC, and how their grip strength and timed up-and-go related to concurrently measured overweight and obesity, adjusted for age, socioeconomic status, and urbanicity. High WC was associated with higher odds of subsequent mobility and IADL limitations. Chronic disease morbidity (sum of self-reported arthritis, high blood pressure, heart disease, diabetes, and cancer) fully mediated the association of high WC with ADL and IADL limitations, but not physical/mobility limitations. Longer up-and-go times, and higher grip strength were related to overweight and obesity. Results emphasize the need for obesity prevention to reduce chronic diseases and maintain good functional status as women age.
Highlights
Obesity has rapidly increased, among lower socioeconomic status (SES) groups in many low and middle-income countries [1]
We aimed to investigate how overweight and obesity relate to physical capacity and to the development of self-reported physical/mobility limitations, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) using data from repeated surveys in the Cebu Longitudinal Health and Nutrition Survey (CLHNS) cohort
We focused on self-reported high blood pressure (BP), heart disease, diabetes, arthritis, and cancer, which were asked in all survey years
Summary
Among lower socioeconomic status (SES) groups in many low and middle-income countries [1]. Longitudinal studies in high income settings among older adults have found that overweight and obesity are associated with increased odds of developing disabilities. WC increased the odds of six-year disability incidence in Dutch adults aged 55 and older [4] and in the US Atherosclerosis Risk in Communities Cohort, obesity at age 25 was associated with increased odds. In the Health ABC study, an 8-fold higher risk of incident mobility limitations after age 70 was reported among individuals who were obese since age 25 [6]. Vincent et al, it was reported that mobility disability (walking, stair climbing, and chair rise ability) was more prevalent with obesity in adults 60 years old and above, and in particular, when BMI exceeded 35 kg/m2 [7]. Rejeski and colleagues in their review [2] noted non-linear effects of BMI, which emphasize the need for studies to examine
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