Is dynapenic abdominal obesity a risk factor for cardiovascular mortality? A competing risk analysis

BACKGROUND: Dynapenic abdominal obesity has been shown as a risk factor for all-cause mortality in older adults. However, there is no evidence on the association between this condition and cardiovascular mortality. OBJECTIVE: We aimed to investigate whether dynapenic abdominal obesity is associated with cardiovascular mortality in individuals aged 50 and older. METHODS: A longitudinal study with an 8-year follow-up was conducted involving 7,030 participants of the English Longitudinal Study of Ageing study. Abdominal obesity and dynapenia were respectively defined based on waist circumference (> 102 cm for men and > 88 cm for women) and grip strength (< 26 kg for men and < 16 kg for women). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). The outcome was cardiovascular mortality. The Fine-Grey regression model was used to estimate the risk of cardiovascular mortality as a function of abdominal obesity and dynapenia status in the presence of competing events controlled by socio-demographic, behavioural and clinical variables. RESULTS: The risk of cardiovascular mortality was significantly higher in individuals with D/AO compared with ND/NAO (SHR 1.85; 95% CI: 1.15-2.97). D/NAO was also associated with cardiovascular mortality (SHR: 1.62; 95% CI: 1.08-2.44). CONCLUSION: Dynapenic abdominal obesity is associated with cardiovascular mortality, with a larger effect size compared to dynapenia alone in individuals older than 50 years. Thus, prevention strategies and clinical interventions that enable mitigating the harmful effects of these conditions should be adopted to diminish such risk

Combination of dynapenia and abdominal obesity affects long-term physical performance trajectories in older adults: Sex differences

BACKGROUND: There is little epidemiological evidence of sex differences in the association between dynapenic abdominal obesity and the decline in physical performance among older adults. OBJECTIVE: The aims of the present study were to investigate whether the decline in physical performance is worse in individuals with dynapenic abdominal obese and whether there are sex differences in this association. METHODS: Out of 6,183 individuals aged 60 years or older from the English Longitudinal Study of Ageing, 2,308 participants with missing data were excluded. Therefore, a longitudinal analysis was conducted with 3,875 older adults. Abdominal obesity was determined based on waist circumference (>102 cm for male and >88 cm for female) and dynapenia was based on grip strength (<26 kg for male <16 kg for female). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). Decline in physical performance in an eight-year follow-up period was analyzed using generalized linear mixed models. RESULTS: At baseline, both male (-1.11 points; 95% CI: -1.58, -0.65; p <0.001) and female (-1.39 points; 95% CI: -1.76, -1.02; p <0.001) with D/AO had worse performances on the Short Physical Performance Battery (SPPB) than their counterparts in the ND/NAO group. Over the eight-year follow-up, male with D/AO had a faster rate of decline in the SPPB performance compared to male in the ND/NAO group (-0.11 points per year; 95% CI: -0.21, -0.01; p = 0.03). CONCLUSION: D/AO is associated with a stronger decline in physical performance in male but not female. The identification and management of dynapenic abdominal obesity may be essential to avoiding the first signs of functional impairment in older male

Sex Differences in Vitamin D Status as a Risk Factor for Incidence of Disability in Instrumental Activities of Daily Living: Evidence from the ELSA Cohort Study

Vitamin D deficiency compromises elements underlying the disability process; however, there is no evidence demonstrating the association between vitamin D deficiency and the incidence of disability in instrumental activities of daily living (IADL). We investigated the association between vitamin D deficiency and the risk of incidence of IADL disability separately in men and women. A total of 4768 individuals aged ≥50 years from the English Longitudinal Study of Aging (ELSA) and without IADL disability according to the Lawton scale were available. Vitamin D was evaluated at baseline by serum 25(OH)D concentrations and classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L) or deficient serum (≤30 nmol/L). IADL were reassessed after 4 years. Poisson models stratified by sex and controlled by covariates demonstrated that deficient serum 25(OH)D was a risk factor for the incidence of IADL disability in men (IRR: 1.43; 95% CI 1.02, 2.00), but not in women (IRR: 1.23; 95% CI 0.94, 1.62). Men appear to be more susceptible to the effect of vitamin D deficiency on the incidence of IADL disability, demonstrating the importance of early clinical investigation of serum 25(OH)D concentrations to prevent the onset of disability

Are Serum 25-Hydroxyvitamin D Deficiency and Insufficiency Risk Factors for the Incidence of Dynapenia?

Epidemiological evidence showing the association between low 25(OH)D and age-related reduction in neuromuscular strength (dynapenia) is a paucity and controversial and, to date, the effect of osteoporosis and vitamin D supplementation on these associations has not been measured. Thus, we analyze whether serum 25(OH)D deficiency and insufficiency are risk factors for the incidence of dynapenia in individuals aged 50 or older and whether osteoporosis or vitamin D supplementation modify these associations. For that, 3205 participants of the ELSA study who were non-dynapenic at baseline were followed for 4 years. Vitamin D was measured at baseline by the serum concentration of 25(OH)D and classified as sufficient (> 50 nmol/L), insufficient (≥ 30 and ≤ 50 nmol/L) or deficient (< 30 nmol/L). The incidence of dynapenia was determined by a grip strength < 26 kg for men and < 16 kg for women at the end of the 4-year follow-up. Poisson regression models were adjusted by sociodemographic, behavioral, clinical and biochemical characteristics. Serum 25(OH)D deficient was a risk factor for the incidence of dynapenia (IRR = 1.70; 95% CI 1.04-2.79). When only individuals without osteoporosis and those who did not use vitamin D supplementation were analyzed, both serum 25(OH)D deficiency (IRR = 1.78; 95% CI 1.01-3.13) and insufficiency (IRR = 1.77; 95% CI 1.06-2.94) were risk factors for the incidence of dynapenia. In conclusion, a serum level of 25(OH)D < 30 nmol/L is a risk factor for the incidence of dynapenia. Among individuals without osteoporosis and those who do not take vitamin D supplementation, the threshold of risk is higher (≤ 50 nmol/L)

Is Abdominal Obesity a Risk Factor for the Incidence of Vitamin D Insufficiency and Deficiency in Older Adults? Evidence from the ELSA Study

Cross-sectional studies have demonstrated an association between abdominal obesity, determined by waist circumference (WC), and vitamin D (25(OH)D) deficiency in older adults. However, longitudinal evidence is based only on general obesity determined using body mass index (BMI). We investigated whether abdominal obesity is associated with the incidence of 25(OH)D insufficiency (&gt;30 and &le;50 nmol/L) and deficiency (&le;30 nmol/L), and whether vitamin D supplementation modifies these associations. We included 2459 participants aged &ge;50 years from the English Longitudinal Study of Ageing (ELSA) with 25(OH)D sufficiency (&gt;50 nmol/L) at baseline. Abdominal obesity was defined as &gt;88 cm for women and &gt;102 cm for men. After 4 years, 25(OH)D concentrations were reassessed. Multinomial logistic regression models controlled by covariates were performed. Abdominal obesity increased the risk of the incidence of 25(OH)D insufficiency (RRR = 1.36; 95% CI: 1.01&ndash;1.83) and deficiency (RRR = 1.64; 95% CI: 1.05&ndash;2.58). These risks were maintained when excluding individuals who took vitamin D supplementation (RRR = 1.38; 95% CI: 1.02&ndash;1.88) and (RRR = 1.62; 95% CI: 1.02&ndash;2.56). Abdominal obesity is associated with the risk of incidence of low 25(OH)D concentrations. WC seems to be an adequate tool for screening individuals with obesity and at potential risk of developing these conditions