The Relationship Between Frailty, Obesity and Social Deprivation in Non-Institutionalized Elderly People
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THE RELATIONSHIP BETWEEN FRAILTY, OBESITY AND SOCIAL DEPRIVATION IN NON-INSTITUTIONALIZED ELDERLY PEOPLE D. MONTEIL1, S. WALRAND2, C. VANNIER-NITENBERG3, B. VAN OOST3, M. BONNEFOY1,4 1. Geriatric Medicine Unit, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre Bénite, France; 2. INRA, Human Nutrition Unit, Center for Research in Human Nutrition Auvergne, Clermont Auvergne University, 63000, Clermont-Ferrand, France; 3. Rhone Health Examination Center, Caisse Primaire d’Assurance Maladie du Rhône, 69003 Lyon; 4. University Claude Bernard Lyon 1, Faculty of Medicine Lyon Sud, 69310 Pierre Bénite, France. Corresponding author: Delphine Monteil, Geriatric Medicine Unit, Lyon Sud Hospital, Hospices Civils de Lyon, 69310 Pierre Bénite, France, [email protected]
Abstract: Background: With the increasing prevalence of obesity and the risk of increased dependency among the elderly, it becomes important to characterize the link between obesity and frailty. The relationship between obesity and social deprivation would be bidirectional, with each influencing the other. Objectives: Main objective was to study the relationship between frailty as defined by Fried and obesity (Body Mass Index (BMI) and abdominal obesity). Secondary objective was to assess the relationship between frailty and social deprivation. Materials and Methods: This was a cross-sectional study, with data collected between January 2014 and December 2015 using a senior periodic health prevention examination form used in the 4 sites of the health examination center, in Rhone, among non-institutionalized seniors (≥ 65 years). Frailty was defined according to Fried’s criteria. Obesity was defined by a BMI ≥ 30 kg / m2 and a waist circumference > 88 cm for women and >102 cm for men. We studied the association between obesity according to BMI ≥ 30kg / m2 on the one hand and abdominal obesity on the other hand with frailty according to Fried. The analyzes were adjusted for gender, age, education level, not being in a relationship and social deprivation quantified by the assessment score of deprivation and health inequalities (EPICES score). Results: 1593 senior health prevention examination forms were studied. According to BMI, senior women were almost twice as likely to be frail when obese (RR = 1.92, 95% CI [1.06 – 3.45], p = 0.018). The results were similar for abdominal obesity in women aged 65-74 years (RR = 2.12, 95% CI [1.03-4.35], p = 0.029). There was no relationship in men for both types of obesity. Seniors who were socially deprived were 2.7 times more likely to be frail than non-deprived seniors (adjusted RR = 2.76, 95% CI [1.808 - 4.203], p 102 cm in men (according to the criteria of the third report of National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III (2001)) (18). Waist circumference was measured only for seniors aged 65 to 74 years.
Results A total 1 593 senior health prevention examination forms were completed from January 1, 2014 to December 31, 2015; there were 718 women and 875 men, and the mean age was 7
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