Purpose

Most studies examining the associations between body composition and health-related quality of life (HRQoL) in older age have been cross-sectional and analyzed only fat or lean mass. Hence, it is poorly known whether fat and lean mass are independently associated with subsequent changes in HRQoL. We investigated whether baseline lean and fat mass are associated with changes in HRQoL over a 10-year period in older adults.

Methods

We studied 1044 men and women from the Helsinki Birth Cohort Study (age 57–70 years at baseline). Bioelectrical impedance analysis was used to derive baseline fat mass index (FMI, fat mass/height²) and lean mass index (lean mass/height²), dichotomized at sex-specific medians. HRQoL was assessed using RAND 36-item Health Survey at baseline and follow-up 10 years later.

Results

When controlled for lean mass and adjusted for potential confounders, high baseline FMI was associated with a greater decline in general health (standardized regression coefficient [β] = − 0.13, p = 0.001), physical functioning (β = − 0.11, p = 0.002), role physical (β = − 0.13, p = 0.003), vitality (β = − 0.08, p = 0.027), role emotional (β = − 0.12, p = 0.007), and physical component score (β = − 0.14, p < 0.001). High baseline FMI was also associated with low HRQoL in all physical domains at baseline (β: from − 0.38 to − 0.10). Lean mass was not strongly associated with HRQoL at baseline or change in HRQoL.

Conclusion

In older community-dwelling adults, higher fat mass is, independent of lean mass, associated with lower physical HRQoL and greater decline in HRQoL. Prevention of adiposity may contribute to preservation of a good quality of life in older age.

中文翻译：

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老年人的身体成分和健康相关生活质量的变化：赫尔辛基出生队列研究的10年随访。

目的

大多数研究检查了老年人的身体成分与健康相关的生活质量（HRQoL）之间的关系，这些研究都是横断面的，仅分析了脂肪或瘦体重。因此，鲜为人知的是，脂肪和瘦体重是否与HRQoL的后续变化独立相关。我们调查了在10年内，老年人的基线瘦肉和脂肪量是否与HRQoL的变化有关。

方法

我们从赫尔辛基出生队列研究中研究了1044名男性和女性（基线年龄57-70岁）。生物电阻抗分析用于得出基线脂肪质量指数（FMI，脂肪质量/高度²）和瘦肉质量指数（lean mass / height ²），并按性别特定的中位数二等分。在基线和10年后的随访中，使用RAND 36个项目的健康调查对HRQoL进行了评估。

结果

当控制瘦体重并调整潜在混杂因素时，高基线FMI与整体健康状况的更大下降（标准回归系数[ β ] =-0.13，p  = 0.001），身体功能（β  =-0.11，p  = 0.002）相关。 ），身体角色（β  = − 0.13，p  = 0.003），活力（β  = − 0.08，p  = 0.027），角色情绪（β  = − 0.12，p  = 0.007）和身体成分评分（β  = − 0.14，p  <0.001）。基线时所有物理域的基线FMI高也与HRQoL低有关（β：从-0.38到-0.10）。基线时，瘦体重与HRQoL或HRQoL的变化没有强烈关系。

结论

在老年人社区中，较高的脂肪量与瘦体重无关，与较低的身体HRQoL和更大的HRQoL下降有关。预防肥胖可能有助于保持老年人的良好生活质量。