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Fitness but not weight status is associated with projected physical independence in older adults.

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Sardinha, Luis B 
Cyrino, Edilson S 
Santos, Leandro Dos 
Ekelund, Ulf 
Santos, Diana A 


Obesity and fitness have been associated with older adults' physical independence. We aimed to investigate the independent and combined associations of physical fitness and adiposity, assessed by body mass index (BMI) and waist circumference (WC) with the projected ability for physical independence. A total of 3496 non-institutionalized older adults aged 65 and older (1167 male) were included in the analysis. BMI and WC were assessed and categorized according to established criteria. Physical fitness was evaluated with the Senior Fitness Test and individual test results were expressed as Z-scores. Projected ability for physical independence was assessed with the 12-item composite physical function scale. Logistic regression was used to estimate the odds ratio (OR) for being physically dependent. A total of 30.1 % of participants were classified as at risk for losing physical independence at age 90 years. Combined fitness and fatness analysis demonstrated that unfit older adults had increased odds ratio for being physically dependent in all BMI categories (normal: OR = 9.5, 95 %CI = 6.5-13.8; overweight: OR = 6.0, 95 %CI = 4.3-8.3; obese: OR = 6.7, 95 %CI = 4.6-10.0) and all WC categories (normal: OR = 10.4, 95%CI = 6.5-16.8; middle: OR = 6.2, 95 %CI = 4.1-9.3; upper: OR = 7.0, 95 %CI = 4.8-10.0) compared to fit participants that were of normal weight and fit participants with normal WC, respectively. No increased odds ratio was observed for fit participants that had increased BMI or WC. In conclusion, projected physical independence may be enhanced by a normal weight, a normal WC, or an increased physical fitness. Adiposity measures were not associated with physical independence, whereas fitness is independently related to physical independence. Independent of their weight and WC status, unfit older adults are at increased risk for losing physical independence.



Adiposity, BMI, Physical fitness, Waist circumference, Adiposity, Aged, Aged, 80 and over, Aging, Body Weight, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Incidence, Male, Obesity, Odds Ratio, Physical Fitness, Portugal, Retrospective Studies, Risk Factors

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Age (Dordr)

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Springer Science and Business Media LLC
Medical Research Council (MC_UU_12015/3)
Medical Research Council (MC_U106179473)
D.A.S. is supported by a scholarship from the Portuguese Foundation for Science and Technology (SFRH/BPD/92462/2013). L.S. conducted this work during a visiting scholar period to the Faculty of Human Kinetics, University of Lisbon, Portugal, supported by the Capes Foundation within the Ministry of Education, Brazil (Process: 88887.065407/2014-00). UE was partly funded by the MRC Epidemiology Unit, University of Cambridge, Cambridge, UK (Grant MC_UU_12015/3)