Bahat Gulistan, Muratlı Sevilay, İlhan Birkan, Tufan Asli, Tufan Fatih, Aydin Yucel, Erten Nilgun, Karan Mehmet Akif
a Department of Internal Medicine, Division of Geriatrics , Istanbul Medical School, Istanbul University , Istanbul , Turkey.
Aging Male. 2015;18(4):228-32. doi: 10.3109/13685538.2015.1061493. Epub 2015 Jul 1.
Disability is utmost important on an aging population's health. Obesity is associated with increased risk for disability. On-the-other-hand, higher-BMI is reported as associated with better functionality in older people in some reports defined as "obesity paradox". There is some evidence on differential relationship between body weight status and functionality by living setting gender, and different populations. We studied the relation between body mass index and functionality in Turkish community dwelling older males accounting for the most confounding factors: age, multimorbidity, polypharmacy and nutritional status. This is a cross-sectional study in a geriatric outpatient clinic of a university hospital. Functionality was assessed with evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Nutrition was assessed by mini-nutritional assessment test. Two hundred seventy-four subjects comprised our study cohort. Mean age was 74.4 ± 7.1 years, BMI was 25.8 ± 4.4 kg/m(2). Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (B = 0.047 and B = 0.128, respectively) (p < 0.05) and better nutritional status (B = 1.94 and B = 3.05, respectively) (p < 0.001) but not with the total number of medications. Higher IADL score was associated with younger age and lower total number of diseases (B = 0.121, B = 0.595, respectively) (p < 0.05) while ADL was not. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling male older people. Our study recommends longitudinal studies with higher participants from different populations, genders and living settings are needed to comment more.
残疾对老年人群的健康极为重要。肥胖与残疾风险增加相关。另一方面，在一些报告中，较高的体重指数（BMI）被报道与老年人更好的功能相关，这被定义为“肥胖悖论”。有证据表明，体重状况与功能之间的关系因生活环境、性别和不同人群而异。我们研究了土耳其社区居住的老年男性的体重指数与功能之间的关系，同时考虑了最具混杂性的因素：年龄、多种疾病、多种药物治疗和营养状况。这是一项在大学医院老年门诊进行的横断面研究。通过评估日常生活活动（ADL）和工具性日常生活活动（IADL）量表来评估功能。通过微型营养评估测试评估营养状况。274名受试者组成了我们的研究队列。平均年龄为74.4±7.1岁，BMI为25.8±4.4kg/m²。线性回归分析显示，较低的BMI与较高的ADL和IADL评分（分别为B = 0.047和B = 0.128）（p < 0.05）以及更好的营养状况（分别为B = 1.94和B = 3.05）（p < 0.001）显著且独立相关，但与药物总数无关。较高的IADL评分与较年轻的年龄和较低的疾病总数相关（分别为B = 0.121，B = 0.595）（p < 0.05），而ADL则不然。我们认为，在土耳其社区居住的老年男性中，较低的BMI与更好的功能状态相关。我们的研究建议，需要进行纵向研究，纳入来自不同人群、性别和生活环境的更多参与者，以便做出更多评论。
