You don’t need to be thin to be frail

Dr Katie Sheehan is a Vancouver based physiotherapist and a recent research fellow at The Irish Longitudinal Study on Ageing. You can see her platform presentation at 11.45 on Friday 21st at the BGS Scientific Meeting.obeseFrailty

Frailty is often thought of as a wasting disorder and, as such, is frequently considered a consequence of ageing incurred by those older adults who present as underweight.  The Fried model of frailty includes reduced gait velocity, low physical activity levels, weakness, exhaustion and weight loss. But frailty isn’t the sole preserve of the thin. As people get older, muscle mass is replaced by fat and physical function deteriorates. This phenomenon offers a particular difficulty for obese older adults who have too low a muscle mass relative to their body size. This mismatch represents a substantial barrier to physical function and may help to explain the recently reported cross sectional ‘U’ shaped relationship between Body Mass Index (BMI) and frailty. This correlation suggests that those who are underweight (body mass index (BMI) < 18.5 kg.m²) and those who are obese (BMI ≥ 30 kg.m²) are more likely to present as frail. Continue reading

Why consider fat distribution in older patients?

Dr Francesco Fantin is Assistant Professor for Geriatric Medicine, University of Verona, Italy.

The waist-hip ratio (WHR) helps to identify the type of fat distribution of our patient

It is known that ageing is associated with a progressive increase in fat mass, in particular visceral adipose tissue, and a decrease in the peripheral subcutaneous adipose tissue.

Several studies have shown the protective role of gluteo-femoral fat for cardiovascular and metabolic diseases. In the last issue of Age and Ageing we showed that arteries are less stiff in women with high levels of gluteo-femoral fat, whereas the arterial stiffness in subjects with high visceral fat mass was higher. These findings confirm and highlight the importance of fat distribution in older post-menopausal women. Continue reading