NGNA SectionSarcopenic Obesity: An Emerging Cause of Frailty in Older Adults
Section snippets
Definitions of Frailty
Recently a standardized definition has been proposed that could be used by clinicians and researchers to identify those who are frail. In this definition, Fried and colleagues9 define frailty as having 3 or more of the following characteristics: shrinking defined as an unintentional weight loss in the previous year, weakness, poor endurance or exhaustion, slowness, and low activity levels. Initial research found that 6.9% of a large sample of community-dwelling older adults displayed 3 or more
Age-Related Changes in Body Composition and Health Risk
Normal aging is associated with changes in body composition. In this article, 2 particular changes are discussed: the loss of lean tissue (primarily muscle) and the increase in adipose tissue.
The Effects of Obesity in Older Adults
Obesity is defined as having more body fat than is good for an individual's health. Body mass index (BMI), which is a ratio of weight to height squared, is currently recommended by the National Heart Lung and Blood Institute (NHLBI)25 to estimate body fat in adults. According to the current NHLBI guidelines, a BMI under 18.5 kg/m2 is considered underweight, a BMI between 18.5 and 25 kg/m2 as normal weight, a BMI between 25 and 30 kg/m2 is overweight, a BMI between 30 and 40 kg/m2 is obesity and
Sarcopenic Obesity and Frailty
Older adults with sarcopenic obesity may experience considerable weakness from a decrease in quantity and quality of muscle mass and also from an increase in the need to move a greater body weight. This was found to be the case in a study that examined the relationships among body composition, physical function, and quality of life in community-dwelling obese elderly persons.28 Obese individuals greater than 65 years of age were matched for age and sex with nonobese frail and nonfrail nonobese
Interventions for Obesity and Frailty in Older Adults
The interventions that reduce frailty in older adults with sarcopenic obesity need to take into account 2 underlying processes: decreased muscle mass and increased adipose tissue mass. Interventions that focus on increasing and improving the quantity and quality of muscle mass as well as interventions that foster appropriate nutrition and weight loss need to be considered.
Conclusion
Sarcopenia and obesity, which are recognized as 2 major causes of disability in older adults, are occurring together and resulting in sarcopenic obesity. Sarcopenic obese older adults have increased amounts of body fat that may mask the sarcopenia, and therefore they may not be recognized as “frail.” The increasing prevalence of obesity in older adults suggests that sarcopenic obesity may become an even greater challenge in the future and an expanded view of frailty that includes obese older
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