(20-06-09) Difficulties with physical function associated with obesity, sarcopenia, and sarcopenic-obesity

in community-dwelling elderly women: the EPIDOS (EPIDemiologie de l'OSteoporose) Study1,2,3



Yves Rolland, Val?rie Lauwers-Cances, Christelle Cristini, Gabor Abellan van Kan, Ian Janssen, John E Morley and Bruno Vellas

1 From Service de M?decine Interne et de G?rontologie Clinique, H?pital La Grave-Casselardit, Toulouse, France (YR, GAvK, and BV); Unit? Inserm 558 (Dr H?l?ne Grandjean), Facult? de M?decine de Toulouse, Toulouse, France (YR, VL-C, and BV); Laboratoire d'?pid?miologie et Sant? Communautaire, Facult? de M?decine, Toulouse, France(VL-C and CC); School of Kinesiology and Health Studies and the Department of Community Health and Epidemiology, Queen's University, Kingston, Canada (IJ); and the Geriatric Research, Education and Clinical Center, Saint Louis VA Medical Center and the Division of Geriatrics, Saint Louis University, Saint Louis, MO (JEM).
2 Supported by the Health Minister of France.
3 Address correspondence to Y Rolland, Service de M?decine Interne et de G?rontologie Clinique, H?pital La Grave-Casselardit, 170 avenue de Casselardit, 31300 Toulouse, France. E-mail: [email protected] .
Background: In elders, decreased muscle mass (sarcopenia) and increased fat mass (obesity) may contribute to difficulties with physical function.
Objective: The objective was to examine the association of obesity, sarcopenia, and their combination (sarcopenic-obesity) with self-reported difficulties performing physical function in a cohort of community-dwelling elderly women.
Design: We assessed muscle and fat mass by dual-energy X-ray absorptiometry and self-reported difficulties with physical function in 1308 healthy women aged 75 y. Sarcopenia was defined as an appendicular skeletal muscle mass 2 SD below the mean in a young female reference group. Obesity was defined as a percentage body fat above the 60th percentile. Thirty-six sarcopenic-obese, 90 purely sarcopenic, 435 purely obese, and 747 women with a healthy body composition were studied. Anthropometric measures, health status, lifestyle habits, and self-reported difficulties with 6 different physical functions were obtained.
Results: Compared with women with a healthy body composition and after adjustment for confounders, purely sarcopenic women had no increased odds of having difficulties for all of the physical functions assessed, purely obese women had a 44?79% higher odds of having difficulties with most of the physical functions assessed (P < 0.05), and sarcopenic-obese women had a 2.60 higher odds of having difficulty climbing stairs and a 2.35 higher odds of having difficulty going down stairs (all P < 0.05).
Conclusions: Sarcopenia is not associated with physical difficulties in the absence of obesity. However, in the presence of obesity, sarcopenia tends to add difficulty for some physical functions.

Source: Am J Clin Nutr 89: 1895-1900, 2009

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