High body fatness, but not low fat-free mass, predicts disability in older men and women: The cardiovascular health study

Marjolein Visser, Jean Langlois, Jack M. Guralnik, Jane A. Cauley, Richard A. Kronmal, John Robbins, Jeff D. Williamson, Tamara B. Harris

Research output: Contribution to journalArticlepeer-review

253 Scopus citations


Using data from the Cardiovascular Health Study, we studied the relation between body composition (fat mass and fat-free mass, assessed by bioelectrical impedance) and self-reported, mobility-related disability (difficulty walking or stair climbing) in 2714 women and 2095 men aged 65- 100 y. In a cross-sectional analysis at baseline (1989-1990), disability was reported by 26.5% of the women and 16.9% of the men. A positive association was observed between fat mass and disability. The odds ratio for disability in the highest quintile of fat mass was 3.04 (95% CI: 2.18, 4.25) for women and 2.77 (95% CI: 1.82, 4.23) for men compared with those in the lowest quintile. Low fat-free mass was not associated with a higher prevalence of disability. In a longitudinal analysis among persons not reporting disability at baseline, 20.3% of the women and 14.8% of the men reported disability 3 y later. Fat mass at baseline was predictive of disability 3 y later, with odds ratios of 2.83 (95% CI: 1.80, 4.46) for women and 1.72 (95% CI: 1.03, 2.85) for men in the highest quintile of fat. The increased risk was not explained by age, physical activity, chronic disease, or other potential confounders. Low fat-free mass was not predictive of disability. The results showed that high body fatness is an independent predictor of mobility-related disability in older men and women. These findings suggest that high body fatness in old age should be avoided to decrease the risk of disability.

Original languageEnglish (US)
Pages (from-to)584-590
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Issue number3
StatePublished - Sep 1998


  • Bioelectrical impedance
  • Body composition
  • Body fat
  • Cardiovascular Health Study
  • Disability
  • Elderly
  • Fat mass
  • Fat-free mass
  • Humans
  • Obesity

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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