A research agenda: the changing relationship between body weight and health in aging.
A research agenda: the changing relationship between body weight and health in aging.
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DOI：
10.1093/gerona/63.11.1257
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发表时间：
2008-11
期刊：
影响因子：
--
通讯作者：
Harris TB
中科院分区：
文献类型：
--
作者：
Alley DE;Ferrucci L;Barbagallo M;Studenski SA;Harris TB
IT is increasingly recognized that changes in weight and body composition with age are strongly connected with health status and physical function. Aging is typically associated with reductions in total and lean mass, so that in the last few years of life, older people frequently report having lost weight and strength (1–3). We know only a few important facts about this process. On average, muscle mass declines with age, and even in older persons with stable weight, muscle is replaced by fat over time (4, 5). Increasing fatty infiltration of muscle tissue is associated with decreasing muscle strength (6). The general pattern of weight change over the lifetime is that weight increases through approximately age 60 years and decreases thereafter (7). Weight gain from early adulthood through midlife is related to increases in both fat and muscle mass, but weight loss at older ages is associated with higher risk for a disproportionate decline in muscle mass (1, 8). In addition to changes in fat and muscle mass, fat location and muscle quality change with age. Waist circumference and intraabdominal visceral fat increase with age at a greater rate than total weight, reflecting changes in the distribution of fat (9, 10). The extent to which individual trajectories of weight and body composition mirror these population average trajectories is unclear (11). Case studies and clinical experience suggest that most individuals actually maintain weight until a period of accelerated body composition change occurs, which parallels deterioration of health status. However, the critical age of acceleration is highly variable between individuals and is perhaps a marker of underlying biological change, as opposed to chronological age. Age-related changes in body composition have important implications for health in late life. Obesity is clearly associated with disability, but the mechanism for this association is not clear. In studies that obtained detailed measures of body composition, muscle strength and fat mass independently predict incident disability and mobility limitation, while there is less evidence for an association between muscle mass and disability (10, 12–17). It is unclear whether obesity and muscle mass or strength act as synergistic risk factors in producing excess risk of disability (14, 15, 17–20). While guidelines exist for healthy body mass index (BMI) with age, consideration of body composition may also be important in clinical assessment. Recently, a working group met in Erice, Italy, to discuss gaps in our understanding of causes and consequences of changes in body weight and composition over the aging process. During a number of formal presentations and in informal discussions that followed, we identified critical research questions that would advance our understanding of the effect of changes in weight and body composition on health, function, and quality of life in older persons. In an effort to focus research on potentially high impact areas, we have selected three of these questions as immediate priorities for publication in an upcoming special section of JGMS.
