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Review article (peer-reviewed)

Journal Thèse soutenue à l'Université de Lausanne
Title of proceedings Thèse soutenue à l'Université de Lausanne

Open Access

Type of Open Access Website


The objective was to study the links between health characteristics, frailty criteria, lifestyles, adiposity and disability in a population-based cohort of non-institutionalized adults aged 65 to 70 years at baseline (N= 1,260 to 1,293). At baseline, frailty was rare (2%), while pre-frailty was common (26%). Pre-frail participants had significantly more comorbidity and disability (defined as help received for activities of daily living, ADL) than non-frail participants. Weakness was the most frequent frailty criterion and was associated with cardio-vascular diseases (CVD). The prevalence of overweight (body mass index (BMI) 25.0-29.9 kg/m2), obesity (BMI ≥30.0 kg/m2), and abdominal obesity (waist circumference (WC) ≥102 cm in men, WC ≥88 cm in women) was 53%, 24%, and 45% in men; 35%, 23%, and 45% in women. Walking and using stairs in daily life was associated with lower adiposity values than doing sports at least once/week. Eating fruit and vegetables at least twice/day, walking and using stairs in daily life, and doing sports ≥once/week were significantly negatively associated with financial difficulties and positively with educational level. In longitudinal analyses, 130 persons died over a median follow-up of 8.47 years. In fully adjusted Cox models, mortality was significantly associated with neither BMI nor WC, but there were trends toward non- significant J curves across both BMI and WC quintiles. Disability (defined as difficulty with BADL or institutionalization, 231 cases) tended to increase monotonically across both BMI and WC quintiles and was significantly associated with BMI quintile 5 (HR=2.44, 95% CI [1.65-3.63]), and WC quintiles 4 (HR=1.81 [1.15-2.85]) and 5 (HR=2.58, [1.67-4.00]). Almost half of the population had a substantially increased HR of disability, as compared to the reference BMI/WC categories. In conclusion, studies with larger sample sizes and longer follow-up should assess the roles of BMI and WC trajectories since midlife and further clarify the shapes of their associations with disability. These findings, together with the literature review, emphasize the need for life-long strategies aimed at preventing excess weight, muscle loss and functional decline through adequate nutrition and regular physical activity, starting at early age and extending throughout life.