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 in older adults. Objectives The aims of the present study were to investigate whether the decline in physical performance is worse in individuals with dynapenic abdominal obesity and whether there are sex differences in this association. Methods Of 6183 individuals aged >= 60 y from the English Longitudinal Study of Ageing, 2308 participants with missing data were excluded. Therefore, a longitudinal analysis was conducted with 3875 older adults. Abdominal obesity was determined based on waist circumference (>102 cm for males, and >88 cm for females), and dynapenia was based on grip strength (<26 kg for males, <16 kg for female). The sample was divided into 4 groups: nondynapenic/nonabdominal obesity (ND/NAO), nondynapenic/abdominal obesity (ND/AO), dynapenic/nonabdominal obesity (D/NAO), and dynapenic/abdominal obesity (D/AO). Decline in physical performance in an 8-y follow-up period was analyzed using generalized linear mixed models. Results At baseline, both male (-1.11 points; 95% CI: -1.58, -0.65 points; P < 0.001) and female (-1.39 points; 95% CI: -1.76, -1.02 points; 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 8-y follow-up, males with D/AO had a faster rate of decline in the SPPB performance compared with males in the ND/NAO group (-0.11 points/y; 95% CI: -0.21, -0.01 points; P = 0.03). Conclusions D/AO is associated with a stronger decline in physical performance in males but not in females. The identification and management of dynapenic abdominal obesity could be essential to avoiding the first signs of functional impairment in older males.