Weakness in the elderly is sometimes thought of as weight loss, including loss of muscle mass, with age, but new research suggests that weight gain may also play a role in the condition.
In a study published Jan. 23 in the journal BMJ Open, researchers from Norway found that people who are overweight in middle age (measured by body mass index (BMI) or waist circumference) have a higher risk of frailty or frailty in the first place. 21 years later.
“Fragility is a powerful barrier to successful aging and aging on your own terms,” said Nikhil Satchidanand, Ph.D., a physiologist and assistant professor at the University at Buffalo, who was not involved in the new study.
Frail older people are at higher risk of falls and injuries, hospitalizations and complications, he said.
In addition, he says, frail older people are more likely to experience a breakdown that leads to a loss of independence and the need to be placed in a long-term care facility.
The results of the new study are consistent with previous long-term studies that have found an association between midlife obesity and pre-fatigue later in life.
The researchers also did not track changes in the participants’ lifestyle, diets, habits, and friendships during the study period that could affect their risk of frailty.
But the authors write that the results of the study highlight “the importance of regularly assessing and maintaining an optimal BMI and [waist circumference] throughout adulthood to reduce the risk of frailty in old age.”
The study is based on survey data from over 4,500 residents aged 45 and over in Tromsø, Norway between 1994 and 2015.
For each survey, the height and weight of the participants were measured. This is used to calculate BMI, which is a screening tool for weight categories that can cause health problems. A higher BMI does not always indicate a higher body fat level.
Some surveys also measured participants’ waist circumference, which was used to estimate belly fat.
In addition, the researchers defined weakness based on the following criteria: unintentional weight loss, wasting, weak grip strength, slow walking speed, and low levels of physical activity.
Frailty is characterized by the presence of at least three of these criteria, while fragility has one or two.
Because only 1% of the participants were weak at the last follow-up visit, the researchers grouped these people with the 28% who were previously weak.
The analysis found that people who were obese in middle age (as indicated by a higher BMI) were almost 2.5 times more likely to suffer from frailty at 21 years compared to people with a normal BMI.
In addition, people with a moderately high or high waist circumference were twice as likely to have prefrastylism/weakness at the last examination compared with people with a normal waist circumference.
The researchers also found that if people gained weight or increased their waist circumference during this period, they were more likely to become weak by the end of the study period.
Satchidanand said the study provides additional evidence that early healthy lifestyle choices can contribute to successful aging.
“This study should remind us that the negative effects of increasing obesity starting in early adulthood are serious,” he said, “and will significantly affect the overall health, functionality, and quality of life of older adults.”
Dr. David Cutler, a family medicine physician at Providence St. Johns Medical Center in Santa Monica, California, said one of the shortcomings of the study is that the researchers focused on the physical aspects of weakness.
On the contrary, “most people will perceive weakness as a deterioration in physical and cognitive functions,” he said.
While the physical criteria that the researchers used in this study have been applied in other studies, some researchers have attempted to explain other aspects of weakness, such as cognitive, social, and psychological aspects.
In addition, participants in the new study reported some indicators of frailty, such as exhaustion, physical inactivity and unexpected weight loss, which means they may not be as accurate, Cutler said.
Another limitation noted by Cutler was that some people dropped out of the study before the last follow-up visit. The researchers found that these people tended to be older, more obese, and had other risk factors for weakness.
However, the results were similar when the researchers excluded people over 60 at the start of the study.
While earlier studies have found an increased risk of frailty in underweight women, the new study included too few underweight people for researchers to test for this link.
Despite the observational nature of the study, the researchers offer several possible biological mechanisms for their findings.
An increase in body fat can lead to inflammation in the body, which is also associated with weakness. They wrote that the deposition of fat in muscle fibers can also lead to reduced muscle strength.
Dr. Mir Ali, bariatric surgeon and medical director of MemorialCare Bariatric Surgery Center at Orange Coast Medical Center in Fountain Valley, Calif., says obesity affects functioning later in life in other ways.
“My obese patients tend to have more joint and back problems,” he says. “This affects their mobility and ability to lead a decent life, including as they age.”
While weakness is somehow linked to aging, Satchidanand said it’s important to remember that not every older person becomes weak.
In addition, “although the underlying mechanisms of weakness are very complex and multidimensional, we have some control over the many factors that contribute to weakness,” he said.
Lifestyle choices, such as regular physical activity, healthy eating, proper sleep hygiene, and stress management, influence weight gain in adulthood, he says.
“There are many factors that contribute to obesity,” he said, including genetics, hormones, access to quality food, and a person’s education, income, and occupation.
While Cutler had some concerns about the limitations of the study, he said the study does suggest that doctors, patients and the public should be aware of the weakness.
“In fact, we do not know how to deal with infirmity. We don’t necessarily know how to prevent it. But we need to know about it,” he said.
Raising awareness of vulnerability is particularly important given the aging population, Satchidanand said.
“As our global society continues to rapidly age and our average life expectancy increases, we are faced with the need to better understand the underlying mechanisms of frailty,” he said, “and develop effective and manageable strategies to prevent and treat frailty syndrome.”
Our experts are constantly monitoring health and wellness and update our articles as new information becomes available.
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