Daily Dose: Obesity and Risk of Frailty

Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On January 27, 2023, we reported on a study published in BMJ Open that examined the association between obesity—assessed using body mass index (BMI) and waist circumference (WC)—and prefrailty/frailty among older adults over 21 years of follow-up.

The study

The prospective cohort study included 4509 persons aged ≥45 years attending the Tromsø study in Norway in 1994–1995 (Tromsø4) and 2015–2016 (Tromsø7), with additional BMI and WC measurements in 2001 (Tromsø5) and 2007–2008 (Tromsø6). For the purposes of the study, physical frailty was defined as the presence of ≥3 and prefrailty as the presence of 1-2 of the following 5 frailty components: low grip strength, slow walking speed, exhaustion, unintentional weight loss, and low physical activity.

Participants with obesity, (adjusted odds ratio [OR] 2.41, 95% CI 1.93-3.02) or overweight (OR 1.19, 95% CI 1.02-1.39) at baseline (assessed by BMI) were significantly more likely to become prefrail/frail at follow-up compared with those with normal BMI. Participants with moderately high WC (OR 1.57, 95% CI 1.21-2.03) or high WC (OR 2.14, 95% CI 1.59 to 2.87) at baseline had higher odds of becoming prefrail/frail at follow-up compared with individuals with a normal WC.

Clinical implications

"Participants with both high BMI and high WC, that is, general and abdominal obesity, especially for a long duration throughout their adulthood, were observed to have an increased likelihood of pre-frailty/frailty. It highlights the importance of routinely assessing and maintaining optimal BMI and WC throughout adulthood to lower the risk of frailty in older age."

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