Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Relationship between body mass index and different domains of disability in older persons: the 3C study

International Journal of Obesity volume 28, pages 1555–1560 (2004)Cite this article

Abstract

OBJECTIVE: To study the relationships between body mass index (BMI) and different domains of disability in elderly subjects from the French 3C study.

SETTING: Three cities in France: Bordeaux (South-West), Dijon (North-East) and Montpellier (South-East).

DESIGN: Cross-sectional study.

SUBJECTS: A sample of 8966 elderly community dwellers (age: 65–101 y).

MEASUREMENTS: Main outcome measures: BMI, continence, basic and Instrumental Activities of Daily Living (ADL and IADL) and mobility. Adjustment variables: age, educational level, lifestyle, cognitive functioning, smoking and drinking history, depression, dyspnea, diabetes and indicator of cardiovascular disease.

RESULTS: Obesity (BMI≥30 kg/m2) was significantly associated with disability in each domain for women. The relationship tended to be linear for ADL and for continence; whereas for IADL, underweight women (BMI <21 kg/m2) were also at higher risk of disability. In men, relationships were weaker since BMI was only associated with mobility restriction, with a higher risk for both underweight and obese subjects.

CONCLUSION: These results are in favor of a strong association between obesity and the three domains of disability and incontinence. Weaker relationships between underweight and disability were observed. Results suggest that maintaining a BMI in the healthy range could contribute to independence in activities of daily living.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. WHO. International Classification of Impairments, Disabilities, and Handicap—a manual of classification relating to the consequences of disease. WHO: Geneva; 1980.

  2. Singer BH, Manton KG . The effects of health changes on projections of health service needs for the elderly population of the United States. Proc Natl Acad Sci USA 1998; 95: 15618–15622.

    Article  CAS  Google Scholar 

  3. Sauvaget C, Tsuji I, Aonuma T, Hisamichi S . Health-life expectancy according to various functional levels. J Am Geriatr Soc 1999; 47: 1326–1331.

    Article  CAS  Google Scholar 

  4. Lawton MP, Brody EM . Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–186.

    Article  CAS  Google Scholar 

  5. Katz S, Downs TD, Cash HR, Grotz RC . Progress in development of the index of ADL. Gerontologist 1970; 10: 20–30.

    Article  CAS  Google Scholar 

  6. Barberger-Gateau P, Rainville C, Letenneur L, Dartigues JF . A hierarchical model of domains of disablement in the elderly: a longitudinal approach. Disabil Rehabil 2000; 22: 308–317.

    Article  CAS  Google Scholar 

  7. Ho SC, Woo J, Yuen YK, Sham A, Chan SG . Predictors of mobility decline: the Hong Kong old-old study. J Gerontol A Biol Sci Med Sci 1997; 52: M356–362.

    Article  CAS  Google Scholar 

  8. The 3C study group. Vascular factors and risk of dementia: design of the Three-City Study and baseline characteristics of the study population. Neuroepidemiology 2003; 22: 316–325.

  9. Rosow I, Breslau NA . Guttman health scale for the aged. J Gerontol 1966; 21: 556–559.

    Article  CAS  Google Scholar 

  10. Guigoz Y, Vellas B, Garry PJ . Mini nutritional assessment: a practical assessment tool for grading the nutritional state of elderly patients. Facts Res Gerontol 1994; 4 (suppl nutrition): 15–59.

    Google Scholar 

  11. Heiat A, Vaccarino V, Krumholz HM . An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med 2001; 161: 1194–1203.

    Article  CAS  Google Scholar 

  12. WHO. The use and interpretation of anthropometry. WHO: Geneva, Switzerland; 1995.

  13. Folstein MF, Folstein SE, Mc Hugh PR . Mini-mental state. A practical method for grading the cognitive state of patients for the clinicians. J Psychiatr Res 1975; 12: 189–198.

    Article  CAS  Google Scholar 

  14. Fuhrer R, Rouillon F, Lellouch J . Diagnostic reliability among French psychiatrists using DSM-III criteria. Acta Psychiatr Scand 1986; 73: 12–16.

    Article  CAS  Google Scholar 

  15. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003; 26: S5–S20.

  16. Guidelines Subcommittee. World Health Organization—international society of hypertension guidelines for the management of hypertension. J Hypertens 1999; 17: 151–183.

  17. Friedmann JM, Elasy T, Jensen GL . The relationship between body mass index and self-reported functional limitation among older adults: a gender difference. J Am Geriatr Soc 2001; 49: 398–403.

    Article  CAS  Google Scholar 

  18. Ferry M, Alix E, Brocker P, Constans T, Lesourd B, Vellas B . Nutrition de la personne âgée, 2e edition Masson: Paris; 1996.

    Google Scholar 

  19. Berlinger WG, Potter JF . Low body mass index in demented outpatients. J Am Geriatr Soc 1991; 39: 973–979.

    Article  CAS  Google Scholar 

  20. Buchsbaum GM, Chin M, Glantz C, Guzick D . Prevalence of urinary incontinence and associated risk factors in a cohort of nuns. Obstet Gynecol 2002; 100: 226–229.

    PubMed  Google Scholar 

  21. Jueng-Anuwat P, Roongruangsilp U, Kochakarn W, Ratana-Olarn K . Risk factors for stress urinary incontinence in middle aged and elderly Thai women. J Med Assoc Thai 2001; 84: 1121–1125.

    CAS  PubMed  Google Scholar 

  22. Davison KK, Ford ES, Cogswell ME, Dietz WH . Percentage of body fat and body mass index are associated with mobility limitations in people aged 70 and older from NHANES III. J Am Geriatr Soc 2002; 50: 1802–1809.

    Article  Google Scholar 

  23. Bannerman E, Miller MD, Daniels LA, Cobiac L, Giles LC, Whitehead C, Andrews GR, Crotty M . Anthropometric indices predict physical function and mobility in older Australians: the Australian Longitudinal Study of Ageing. Public Health Nutr 2002; 5: 655–662.

    Article  Google Scholar 

  24. Zoico E, Di Francesco V, Guralnik JM, Mazzali G, Bortolani A, Guariento S, Sergi G, Bosello O, Zamboni M . Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. Int J Obes Relat Metab Disord 2004; 28: 234–241.

    Article  CAS  Google Scholar 

  25. Jensen GL, Friedmann JM . Obesity is associated with functional decline in community-dwelling rural older persons. J Am Geriatr Soc 2002; 50: 918–923.

    Article  Google Scholar 

  26. Evers Larsson U, Mattsson E . Functional limitations linked to high body mass index, age and current pain in obese women. Int J Obes Relat Metab Disord 2001; 25: 893–899.

    Article  CAS  Google Scholar 

  27. Deschamps V, Astier X, Ferry M, Rainfray M, Emeriau JP, Barberger-Gateau P . Nutritional status of healthy elderly persons living in Dordogne, France, and relation with mortality and cognitive or functional decline. Eur J Clin Nutr 2002; 56: 305–312.

    Article  CAS  Google Scholar 

  28. Ostbye T, Taylor DHJ, Krause KM, Van Scoyoc L . The role of smoking and other modifiable lifestyle risk factors in maintaining and restoring lower body mobility in middle-aged and older Americans: results from the HRS and AHEAD. Health and Retirement Study. Asset and Health Dynamics Among the Oldest Old. J Am Geriatr Soc 2002; 50: 691–699.

    Article  Google Scholar 

  29. Trakas K, Oh PI, Singh S, Risebrough N, Shear NH . The health status of obese individuals in Canada. Int J Obes Relat Metab Disord 2001; 25: 662–668.

    Article  CAS  Google Scholar 

  30. Launer LJ, Harris T, Rumpel C, Madans J . Body mass index, weight change, and risk of mobility disability in middle-aged and older women. The epidemiologic follow-up study of NHANES I. JAMA 1994; 271: 1093–1098.

    Article  CAS  Google Scholar 

  31. Lopez-Garcia E, Banegas JR, Gutierrez-Fisac JL, Perez-Regadera AG, Ganan LD, Rodriguez-Artalejo F . Relation between body weight and health-related quality of life among the elderly in Spain. Int J Obes Relat Metab Disord 2003; 27: 701–709.

    Article  CAS  Google Scholar 

  32. Ferraro KF, Su YP, Gretebeck RJ, Black DR, Badylak SF . Body mass index and disability in adulthood: a 20-year panel study. Am J Public Health 2002; 92: 834–840.

    Article  Google Scholar 

  33. Han TS, Tijhuis MA, Lean ME, Seidell JC . Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998; 88: 1814–1820.

    Article  CAS  Google Scholar 

  34. Kolotkin RL, Head S, Hamilton M, Tse CK . Assessing impact of weight on quality of life. Obes Res 1995; 3: 49–56.

    Article  CAS  Google Scholar 

  35. Larsson UE, Mattsson E . Perceived disability and observed functional limitations in obese women. Int J Obes Relat Metab Disord 2001; 25: 1705–1712.

    Article  CAS  Google Scholar 

  36. Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, Rimm E, Colditz GA . Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 2001; 161: 1581–1586.

    Article  CAS  Google Scholar 

  37. Zamboni M, Turcato E, Santana H, Maggi S, Harris TB, Pietrobelli A, Heymsfield SB, Micciolo R, Bosello O . The relationship between body composition and physical performance in older women. J Am Geriatr Soc 1999; 47: 1403–1408.

    Article  CAS  Google Scholar 

  38. Crimmins EM, Hayward MD, Saito Y . Differentials in active life expectancy in the older population of the United States. J Gerontol B Psychol Sci Soc Sci 1996; 51: 111–120.

    Article  Google Scholar 

  39. Galanos AN, Pieper CF, Cornoni-Huntley JC, Bales CW, Fillenbaum GG . Nutrition and function: is there a relationship between body mass index and the functional capabilities of community-dwelling elderly? J Am Geriatr Soc 1994; 42: 368–373.

    Article  CAS  Google Scholar 

  40. Janssen I, Heymsfield SB, Ross R . Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002; 50: 889–896.

    Article  Google Scholar 

  41. Manandhar MC . Functional ability and nutritional status of free-living elderly people. Proc Nutr Soc 1995; 54: 677–691.

    Article  CAS  Google Scholar 

  42. LaCroix AZ, Guralnik JM, Berkman LF, Wallace RB, Satterfield S . Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity, and body mass index. Am J Epidemiol 1993; 137: 858–869.

    Article  CAS  Google Scholar 

  43. Sturm R . The effects of obesity, smoking, and drinking on medical problems and costs. Obesity outranks both smoking and drinking in its deleterious effects on health and health costs. Health Aff (Millwood) 2002; 21: 245–253.

    Article  Google Scholar 

  44. Silventoinen K, Sans S, Tolonen H, Monterde D, Kuulasmaa K, Kesteloot H, Tuomilehto J, Project WM . Trends in obesity and energy supply in the WHO MONICA Project. Int J Obes Relat Metab Disord 2004; 28: 710–718.

    Article  CAS  Google Scholar 

  45. Sturm R, Ringel JS, Andreyeva T . Increasing obesity rates and disability trends. Health Aff (Millwood) 2004; 23: 199–205.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Epidemiology Research Unit, Institut National de la Santé et de la Recherche Médicale (INSERM) U 593, Bordeaux, 33 076, Cedex, France

    S Larrieu, K Pérès, L Letenneur, J F Dartigues & P Barberger-Gateau

  2. INSERM E 0361, Montpellier, 34 093, Cedex 5, France

    C Berr & K Ritchie

  3. INSERM U 360, Paris, 75 651, Cedex 13, France

    B Février & A Alpérovitch

Authors
  1. S Larrieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K Pérès
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L Letenneur
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Berr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J F Dartigues
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K Ritchie
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B Février
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A Alpérovitch
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P Barberger-Gateau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Larrieu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Larrieu, S., Pérès, K., Letenneur, L. et al. Relationship between body mass index and different domains of disability in older persons: the 3C study. Int J Obes 28, 1555–1560 (2004). https://doi.org/10.1038/sj.ijo.0802755

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802755

Keywords

This article is cited by

Search

Advanced search

Quick links