Adiposity measures and pre-frailty/frailty among community-dwelling older adults: The Tromsø Study 1994–2016

• Main Author: Uchai, Shreeshti
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: 2024
• Subjects: Tromsø
• Online Access: http://hdl.handle.net/10852/112705

Frailty poses a significant challenge to healthy ageing by compromising older adults' ability to cope with stressors and increasing their risk of adverse health outcomes. Pre-frailty, an intermediate state, often precedes frailty and presents a critical window for prevention, delay or reversal of frailty progression. Frailty has usually been associated with underweight; however, growing evidence indicates a link between obesity and frailty development as well. This is particularly concerning given the rising prevalence of obesity in an ageing world. Understanding the long-term association between obesity and frailty can enhance our understanding of frailty development, offering insights into its prevention and management. So, in this thesis, we assessed the longitudinal association of different adiposity measures—anthropometric (body mass index, waist circumference) and dual-energy X-ray absorptiometry (DXA)-derived (fat mass index, visceral adipose tissue mass)—with frailty status among older adults (≥65 years) using data from the large population-based Tromsø Study. Additionally, acknowledging the existing health disparities, we cross-sectionally examined whether these associations differed by social position. The three studies in this thesis consistently demonstrated a positive association of both anthropometric and DXA-derived adiposity measures with frailty status. We observed variations in the strength of these associations by sex and social position for certain adiposity measures, underscoring the importance of considering these factors in this context. Nevertheless, the likelihood of pre-frailty/frailty increased with higher adiposity. Obesity around mid-life and at an older age, especially for a longer duration, was associated with pre-frailty/frailty. This finding suggests that preventing excess adiposity and maintaining optimal body composition throughout adulthood could help prevent or delay the onset and worsening of frailty, thereby promoting healthy ageing.