Body composition and changes in health-related quality of life in older age: a 10-year follow-up of the Helsinki Birth Cohort Study

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Abstract

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/height ²) and lean mass index (lean mass/height ²), 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.

Related collections

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To calibrate eight-polar bioelectrical impedance analysis (BIA) against dual-energy X-ray absorptiometry (DXA) for the assessment of total and appendicular body composition in healthy adults. A cross-sectional study was carried out. Sixty-eight females and 42 males aged 21-82 years participated in the study. Whole-body fat-free mass (FFM) and appendicular lean tissue mass (LTM) were measured by DXA; resistance (R) of arms, trunk and legs was measured by eight-polar BIA at frequencies of 5, 50, 250 and 500 kHz; whole-body resistance was calculated as the sum R of arms, trunk and legs. The resistance index (RI), i.e. the height(2)/resistance ratio, was the best predictor of FFM and appendicular LTM. As compared with weight (Wt), RI at 500 kHz explained 35% more variance of FFM (vs 0.57), 45% more variance of LTM(arm) (vs 0.48) and 36% more variance of LTM(leg) (vs 0.50) (p < 0.0001 for all). The contribution of age to the unexplained variance of FFM and appendicular LTM was nil or negligible and the RI x sex interactions were either not significant or not important on practical grounds. The percent root mean square error of the estimate was 6% for FFM and 8% for LTM(arm) and LTM(leg). Eight-polar BIA offers accurate estimates of total and appendicular body composition. The attractive hypothesis that eight-polar BIA is influenced minimally by age and sex should be tested on larger samples including younger individuals.

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Author and article information

Contributors

Tuija M. Mikkola:

ORCID: http://orcid.org/0000-0003-0885-2788

tuija.mikkola@folkhalsan.fi

Journal

Journal ID (nlm-ta): Qual Life Res

Journal ID (iso-abbrev): Qual Life Res

Title: Quality of Life Research

Publisher: Springer International Publishing (Cham )

ISSN (Print): 0962-9343

ISSN (Electronic): 1573-2649

Publication date (Electronic): 2 March 2020

Publication date PMC-release: 2 March 2020

Publication date (Print): 2020

Volume: 29

Issue: 8

Pages: 2039-2050

Affiliations

[1 ]GRID grid.428673.c, ISNI 0000 0004 0409 6302, Folkhälsan Research Center, ; Helsinki, Finland

[2 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Clinicum, Faculty of Medicine, , University of Helsinki, ; Helsinki, Finland

[3 ]GRID grid.410705.7, ISNI 0000 0004 0628 207X, Primary Health Care Unit, , Kuopio University Hospital, ; Kuopio, Finland

[4 ]GRID grid.9681.6, ISNI 0000 0001 1013 7965, Gerontology Research Center, Faculty of Sport and Health Sciences, , University of Jyväskylä, ; Jyvaskyla, Finland

[5 ]GRID grid.14758.3f, ISNI 0000 0001 1013 0499, Public Health Promotion Unit, , National Institute for Health and Welfare, ; Helsinki, Finland

[6 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Department of General Practice and Primary Health Care, , University of Helsinki and Helsinki University Hospital, ; Helsinki, Finland

[7 ]GRID grid.412326.0, ISNI 0000 0004 4685 4917, PEDEGO Research Unit, MRC Oulu, , Oulu University Hospital and University of Oulu, ; Oulu, Finland

[8 ]GRID grid.5947.f, ISNI 0000 0001 1516 2393, Department of Clinical and Molecular Medicine, , Norwegian University for Science and Technology, ; Trondheim, Norway

[9 ]GRID grid.15485.3d, ISNI 0000 0000 9950 5666, Children’s Hospital, , Helsinki University Hospital and University of Helsinki, ; Helsinki, Finland

[10 ]GRID grid.452264.3, ISNI 0000 0004 0530 269X, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, ; Singapore, Singapore

[11 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, , National University of Singapore, ; Singapore, Singapore

Author information

Tuija M. Mikkola http://orcid.org/0000-0003-0885-2788

Article

Publisher ID: 2453

DOI: 10.1007/s11136-020-02453-1

PMC ID: 7363735

PubMed ID: 32124264

SO-VID: 6ec1e27a-19fc-4480-b5d2-674d5c3eca1e

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 17 February 2020