Mortality, sarcopenic obesity, and sarcopenia: Frailty in Brazilian Older People Study – FIBRA – RJ

Authors

  • Glaucia Cristina de Campos Universidade Federal do Espírito Santo. Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Vitória, ES, Brasil https://orcid.org/0000-0002-1358-3503
  • Roberto Alves Lourenço Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Medicina Interna. Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0003-0838-1285
  • Maria del Carmen Bisi Molina Universidade Federal do Espírito Santo. Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Vitória, ES, Brasil https://orcid.org/0000-0002-8614-988X

DOI:

https://doi.org/10.11606/s1518-8787.2021055002853

Keywords:

Aged, Sarcopenia, epidemiology, Obesity, Sarcopenic Obesity, Risk Factors, Mortality

Abstract

OBJECTIVE: To investigate the risk of mortality associated with sarcopenic obesity (SO), obesity (OB), and sarcopenia in elderlies. METHODS: We analyzed longitudinal data from 270 participants > 65 years of age of Phase III of the Study on Frailty in Brazilian Older People (FIBRA–RJ–2012). Socioeconomic, demographic, lifestyle, morbidity, and functional data were collected by home based interviews. DXA and body composition assessment was conducted in a laboratory. In women, OB was diagnosed when body fat percentage ≥ 38% and sarcopenia by an Appendicular Lean Mass Index (ALMI) < 6.00 kg/m² and muscle strength < 16 Kgf. In men, OB was diagnosed when body fat percentage ≥ 27%, and sarcopenia was diagnosed with ALMI < 7.00 kg/m² and muscle strength < 27 Kgf. SO was assessed by combining variables used to diagnose obesity and sarcopenia. The probabilistic linkage method was used to obtain deaths in the 2012-January 2017 period from the Brazilian Mortality Registry. Cox regression models were tested, and crude and adjusted hazard ratio calculations were conducted. RESULTS: After adjusting for sex, age, race/skin color, walking as an exercise, and hypertension, individuals with sarcopenia were 5.7 times more likely to die (95%CI: 1.17–27.99) than others without sarcopenia and obesity. CONCLUSION: A high risk of death was observed in individuals with sarcopenia. These results show the need for preventive strategies of early detection and treatment in order to increase survival employing multimodal interventions.

References

Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018;14(9):513-37. https://doi.org/10.1038/s41574-018-0062-9

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169

Batsis JA, Mackenzie TA, Barre LK, Lopez-Jimenez F, Bartels SJ. Sarcopenia, sarcopenic obesity and mortality in older adults: results from the National Health and Nutrition Examination Survey III. Eur J Clin Nutr. 2014;68(9):1001-7. https://doi.org/10.1038/ejcn.2014.117

Tian S, Xu Y. Association of sarcopenic obesity with the risk of all-cause mortality: a meta-analysis of prospective cohort studies. Geriatr Gerontol Int. 2016;16(2):155-66. https://doi.org/10.1111/ggi.12579

Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309(1):71-82. https://doi.org/10.1001/jama.2012.113905

Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG. Sarcopenic obesity and risk of cardiovascular disease and mortality: a population‐based cohort study of older men. J Am Geriatric Soc. 2014;62(2):253-60. https://doi.org/10.1111/jgs.12652

Souza RGM, Gomes AC, Prado CMM, Mota JF. Métodos de análise da composição corporal em adultos obesos. Rev Nutr. 2014;27(5):569-83. https://doi.org/10.1590/1415-52732014000500006

Gupta N, Balasekaran G, Govindaswamy VV, Hwa CY, Shun LM. Comparison of body composition with bioelectric impedance (BIA) and dual-energy X-ray absorptiometry (DEXA) among Singapore Chinese. J Sci Med Sport. 2011;14(1):33-5. https://doi.org/10.1016/j.jsams.2010.04.005

Castro EA, Lima LM, Amaral JF, Cerqueira MS, Doimo LA. Comparação entre equações estimativas e DXA para avaliação da gordura corporal em mulheres não sedentárias. Motricidade. 2012 8 Supl 2:348-56. Available from: https://www.redalyc.org/pdf/2730/273023568042.pdf

Lourenço RA, Sanchez MA, Moreira VG, Ribeiro PCC, Perez M, Campos GC, et al. Fragilidade em Idosos Brasileiros-FIBRA-RJ: metodologia de pesquisa dos estudos de fragilidade, distúrbios cognitivos e sarcopenia. Rev HUPE. 2015;14(4): 13-23. https://doi.org/10.12957/rhupe.2015.20066

Kim JH, Lim S, Choi SH, Kim KM, Yoon JW, Kim KW, et al. Sarcopenia: an independent predictor of mortality in community-dwelling older Korean men. J Gerontol A Biol Sci Med Sci. 2014;69(10):1244-52. https://doi.org/10.1093/gerona/glu050

Liu LK, Chen LY, Yeh KP, Lin MH, Hwang AC, Peng LN, et al. Sarcopenia, but not sarcopenic obesity, predicts mortality for older old men: a 3-year prospective cohort study. J Clin Geront Geriatr. 2014;5(2):42-6. https://doi.org/10.1016/j.jcgg.2014.01.002

Sanada K, Chen R, Willcox B, Ohara T, Wen A, Takenaka C, et al. Association of sarcopenic obesity predicted by anthropometric measurements and 24-y all-cause mortality in elderly men: The Kuakini Honolulu Heart Program. Nutrition. 2018;46:97-102. https://doi.org/10.1016/j.nut.2017.09.003

Hirani V, Naganathan V, Blyth F, Le Couteur DG, Seibel MJ, Waite LM, et al. Longitudinal associations between body composition, sarcopenic obesity and outcomes of frailty, disability, institutionalisation and mortality in community-dwelling older men: The Concord Health and Ageing in Men Project. Age Ageing. 2017;46(3):413-20. https://doi.org/10.1093/ageing/afw214

Stenholm S, Mehta NK, Elo IT, Heliövaara M, Koskinen S, Aromaa A. Obesity and muscle strength as long-term determinants of all-cause mortality: a 33-year follow-up of the Mini-Finland Health Examination Survey. Int J Obes (Lond). 2014;38(8):1126-32. https://doi.org/10.1038/ijo.2013.214

Karlsen T, Nauman J, Dalen H, Langhammer A, Wisløff U. The combined association of skeletal muscle strength and physical activity on mortality in older women: the HUNT2 study. Mayo Clinic Proc. 2017;92(5):710-8. https://doi.org/10.1016/j.mayocp.2017.01.023

Beaudart C, Reginster JY, Petermans J, Gillain S, Quabron A, Slomian J, et al. Quality of life and physical components linked to sarcopenia: The SarcoPhAge Study. Exp Gerontol. 2015;69:103-10. https://doi.org/10.1016/j.exger.2015.05.003

Rolland Y, Gallini A, Cristini C, Schott AM, Blain H, Beauchet O, et al. Body-composition predictors of mortality in women aged ≥75 y: data from a large population-based cohort study with a 17-y follow-up. Am J Clin Nutr. 2014;100(5):1352-60. https://doi.org/10.3945/ajcn.114.086728

Steihaug OM, Gjesdal CG, Bogen B, Kristoffersen MH, Lien G, Ranhoff AH. Sarcopenia in patients with hip fracture: a multicenter cross-sectional study. PLoS One. 2017;12(9):e0184780. https://doi.oeg/10.1371/journal.pone.0184780

Santos EP, Gadelha AB, Safons MP, Nóbrega OT, Oliveira RJ, Lima RM. Sarcopenia and sarcopenic obesity classifications and cardiometabolic risks in older women. Arch Gerontol Geriatr. 2014;59(1):56-61. https://doi.org/10.1016/j.archger.2014.03.012

Kohara K. Sarcopenic obesity in aging population: current status and future directions for research. Endocrine. 2014;45(1):15-25. https://doi.org/10.1007/s12020-013-9992-0

Batsis JA, Barre LK, Mackenzie TA, Pratt SI, Lopez‐Jimenez F, Bartels SJ. Variation in the prevalence of sarcopenia and sarcopenic obesity in older adults associated with different research definitions: dual‐energy x‐ray absorptiometry data from the National Health and Nutrition Examination Survey 1999-2004. J Am Geriatr Soc. 2013;61(6):974-80. https://doi.org/10.1111/jgs.12260

Moon JH, Kong MH, Kim HJ. Implication of sarcopenia and sarcopenic obesity on lung function in healthy elderly: using Korean National Health and Nutrition Examination Survey. J Korean Med Sci. 2015;30(11):1682-8. https://doi.org/10.3346/jkms.2015.30.11.1682

Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. Sarcopenic obesity: a new category of obesity in the elderly. Nutr Metab Cardiovasc Dis. 2008;18(5):388-95. https://doi.org/10.1016/j.numecd.2007.10.002

Cabrera MAS, Jacob Filho W. Obesidade em idosos: prevalência, distribuição e associação com hábitos e co-morbidades. Arq Bras Endocrinol Metabol. 2001;45(5):494-501. https://doi.org/10.1590/S0004-27302001000500014

Silveira EA, Kac G, Barbosa LS. Prevalência e fatores associados à obesidade em idosos residentes em Pelotas, Rio Grande do Sul, Brasil: classificação da obesidade segundo dois pontos de corte do índice de massa corporal. Cad Saude Publica. 2009;25(7):1569-77. https://doi.org/10.1590/S0102-311X2009000700015

Ryu M, Jo J, Lee Y, Chung YS, Kim KM, Baek WC. Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey. Age Ageing. 2013;42(6):734-40. https://doi.org/10.1093/ageing/aft063

Van Aller C, Lara J, Stephan BCM, Donini LM, Heymsfield S, Katzmarzyk PT, et al. Sarcopenic obesity and overall mortality: results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999-2004. Clin Nutr. 2019;38(1):264-70. https://doi.org/10.1016/j.clnu.2018.01.022

Bouchard DR, Dionne IJ, Brochu M. Sarcopenic/obesity and physical capacity in older men and women: data from the Nutrition as a Determinant of Successful Aging (NuAge)—the Quebec Longitudinal Study. Obesity. 2009;17(11):2082-8. https://doi.org/10.1038/oby.2009.109

Polyzos SA, Margioris AN. Sarcopenic obesity. Hormones (Athens). 2018;17(3):321-31. https://doi.org/10.1007/s42000-018-0049-x

Saitoh M, Ishida J, Springer J. Physical activity for the prevention and treatment of sarcopenic obesity. J Cachexia Sarcopenia Muscle. 2017;8(3):518-9. https://doi.org/10.1002/jcsm.12216

Waters DL, Baumgartner RN. Sarcopenia and obesity. Clin Geriatric Med. 2011;27(3):401-21. https://doi.org/10.1016/j.cger.2011.03.007

Downloads

Published

2021-11-22

Issue

Section

Original Articles

How to Cite

Campos, G. C. de, Lourenço, R. A., & Molina, M. del C. B. (2021). Mortality, sarcopenic obesity, and sarcopenia: Frailty in Brazilian Older People Study – FIBRA – RJ. Revista De Saúde Pública, 55, 75. https://doi.org/10.11606/s1518-8787.2021055002853