Abstract
The increasing prevalence of obesity among the institutionalised elderly population and its severe consequences on health requires an early and accurate diagnosis that can be easily achieved in any clinical setting. This study aimed to determine new cut-off values for anthropometric and bioelectrical impedance measures that are superior to body mass index criteria for overweight and obesity status in a sample of Spanish institutionalised elderly population. A total of 211 institutionalised older adults (132 women, aged 84.3±7.3 years; 79 men, aged 81.5±7.3 years) were enrolled in the current cross-sectional study. Anthropometric and bioelectrical impedance measures included the body mass index, waist circumference, gluteal circumference, waist-hip ratio, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio. In women, the waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat index presented strongly significant specificity and sensitivity (area under the curve [AUC], p<0.0001) and elevated discriminative values (receiver operating characteristic [ROC] curves: 0.827 to 0.867) for overweight and obesity status. In men, the waist-hip ratio, waist circumference, gluteal circumference, sagittal-abdominal diameter, trunk fat, and visceral-fat ratio were strongly significant AUC (p<0.0001), with moderate-to-high values (ROC curves: 0.757-0.871). In conclusion, our findings suggest that gluteal circumference, waist circumference, and sagittal-abdominal diameter in women and trunk fat, visceral-fat ratio, and waist circumference in men may represent more suitable cut-off values superior to body mass index criteria for overweight and obesity in the Spanish institutionalised elderly population.
Highlights
The prevalence of obesity among older European adults has reached epidemic proportions [1]
The waist circumference (WC), gluteal circumference, sagittal abdominal diameter (SAD), trunk fat (Tfat), and visceral fat ratio (VFR) showed significantly different areas under the curve (AUC) values compared to body mass index (BMI) with high AUC values (Table 2)
In agreement with previous studies focused on German and Australian adults [18, 19], our findings revealed that there was a stronger correlation between WC and BMI when compared to waist-hip ratio (WHR) and BMI
Summary
The prevalence of obesity among older European adults has reached epidemic proportions [1]. In Spain, increasing prevalence of obesity coupled with the growth of this population group has become a matter of major concern in recent decades [2]. Obesity has been reported as a major risk factor for institutionalisation [6]. A recent systematic review has revealed an association between obesity with increased morbidity and functional decline [7]. Overweight and obesity status have been significantly associated with poor cognitive performance among Spanish institutionalised elderly individuals [8]. The obesity status of institutionalised residents may have a negative impact on staff, equipment, and services provided in NH [9]. Obesity status has been considered a criterion of non-admission in NH when choosing prospective residents [9]
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