Meng-Chih Lee, Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Sec. 1, Sanmin Rd., West Dist., Taichung City 403, Taiwan, Phone No: 886-4-22294411, Fax No: 886-4-22229517, Email Address:
J Nutr Health Aging. 2019;23(9):849-855. doi: 10.1007/s12603-019-1226-6.
Few studies have focused on weight change and frailty, especially in Asia. This research aimed to evaluate midlife body mass index (BMI) trajectory and assess its relationship with frailty 8 years later in Taiwan.
A prospective cohort study.
Data were retrieved from the Taiwan Longitudinal Study on Aging conducted from 1999 to 2007. The analysis was restricted to respondents aged between 50 to 69 years old, who were not frail in 1999 and were alive in 2007 (n=1609).
Frailty was defined using the Fried criteria. The group-based model of trajectory was used to estimate BMI trajectories among elderly participants. Logistic regression analysis was used to examine the association between BMI change and frailty.
Four trajectory classes were identified and each remained stable during the 8-year follow-up. There were 316 participants (20.3%) in the low-normal weight group (baseline BMI=20.38 kg/m2), 737 participants (44.7%) in the high-normal weight group (baseline BMI=23.22 kg/m2), 449 participants (28.4%) in the overweight group (baseline BMI=26.24 kg/m2), and 107 participants (6.6%) in the obesity group (baseline BMI=30.65 kg/m2). After adjustment for confounding factors, the low-normal weight group and obesity group were associated with increased frailty compared with the high-normal weight group.
Our results showed that the BMI trajectories of midlife individuals tended to be constant and those in both the low-normal weight group and obesity group had an increased risk of developing frailty in later life. Therefore, an optimal weight-targeting strategy should be considered for Asian elderly individuals.
鲜有研究关注体重变化与虚弱问题,尤其是在亚洲。本研究旨在评估台湾中年人体重指数(BMI)轨迹,并评估其与 8 年后虚弱的关系。
前瞻性队列研究。
数据来自于 1999 年至 2007 年开展的台湾老年人纵向研究。分析仅限于年龄在 50 至 69 岁之间、1999 年无虚弱且 2007 年存活的受访者(n=1609)。
采用 Fried 标准定义虚弱。采用基于群组的轨迹模型估计老年参与者的 BMI 轨迹。采用 logistic 回归分析检验 BMI 变化与虚弱的关系。
确定了 4 种轨迹类别,每种类别在 8 年随访期间均保持稳定。低正常体重组(基线 BMI=20.38kg/m2)有 316 名参与者(20.3%),高正常体重组(基线 BMI=23.22kg/m2)有 737 名参与者(44.7%),超重组(基线 BMI=26.24kg/m2)有 449 名参与者(28.4%),肥胖组(基线 BMI=30.65kg/m2)有 107 名参与者(6.6%)。调整混杂因素后,与高正常体重组相比,低正常体重组和肥胖组发生虚弱的风险增加。
我们的研究结果表明,中年个体的 BMI 轨迹趋于稳定,低正常体重组和肥胖组在晚年发生虚弱的风险增加。因此,亚洲老年人应考虑采用优化的体重目标策略。