Waist circumference and weight change are associated with disability among elderly Hispanics

Background. Studies have suggested that both high and low body mass index (BMI) and weight change are related to functional disability in elderly populations. Elderly Hispanics have a high prevalence of both obesity and disability, yet few studies have examined their interrelationship in this population. Therefore. we examined these relationships in a mostly Puerto Rican group of Hispanic elders. Methods. We investigated associations between a three-level disability score created from responses to a questionnaire on activities of daily living and BMI, waist circumference (WC), and weight change since age 50, using the proportional odds model in a cross-sectional study of 763 elderly Hispanics. aged 60 to 92 years, residing in Massachusetts. Results. After adjusting for potential confounders, men with a WC greater than or equal to109.3 cm (vs <90 cm), or with a reported weight loss of -0.32 to -0.01 kg/year, or a weight gain greater than or equal to0.55 kg/year since age 50 (vs relatively stable weight, -0.01 to +0.21 kg/year [y]) were each significantly associated with an approximately threefold higher risk for greater disability. Women with a BMI :35 kg/m(2) were almost four times as likely to have higher disability as those with a BMI of 20 to 25 kg/m2. Compared with women with a WC less than or equal to85.2 cm, those with a WC of 91.5 to 106.6 cm were two times more likely, and those with a WC 2:106.6 cm were five times more likely, to have higher disability scores. Compared with relatively stable weight (-0.05 to +0.23 kg/y), weight gain greater than or equal to0.23 kg/year was associated with a twofold higher risk of greater disability among women. When BMI and WC were included in the same model, WC, but not BMI, remained significantly associated with disability. Conclusions. Abdominal obesity (WC greater than or equal to109.3 cm for men, or WC greater than or equal to91.5 cm for women) and weight gain greater than or equal to0.55 kg/year after age 50 in men or greater than or equal to0.23 kg/year in women may increase the risk of disability among elderly Hispanics.