Exploring cut-off values for large waist circumference in older adults: a new methodological approach.

BACKGROUND

There is an ongoing debate about the applicability of current criteria for large waist circumference (WC) in older adults.

OBJECTIVES

Our aim was to explore cut-off values for large WC in adults aged 70 years and older, using previously used and new methods.

DESIGN

Prospective cohort study.

PARTICIPANTS

Data of 1049 participants of the Longitudinal Aging Study Amsterdam (LASA) (1995-1996), aged 70-88y, were used.

MEASUREMENTS

Measured BMI and WC, and self-reported mobility limitations.

RESULTS

Linear regression analyses showed that the values of WC corresponding to BMI of 25kg/m2 and 30kg/m2 were higher than the current cut-offs. Cut-offs found in men were 97 and 110cm, whereas 88 and 98cm represented the cut-offs in women. Areas under the Receiver Operating Characteristic (ROC) curves showed that the accuracy to predict mobility limitations improved when the higher cut-offs were applied. Spline regression curves showed that the relationship of WC with mobility limitations was U-shaped in men, while in women, the risk for mobility limitations increased gradually with increasing WC. However, at the level of current cut-off values for WC the odds for mobility limitations were not increased.

CONCLUSION

Based on results of extensive analyses, this study suggests that the cut-offs for large WC should be higher when applied to older adults. The association of WC with other negative health outcomes needs to be investigated to establish the final cut-points.