Abstract：
OBJECTIVE: We aimed to determine whether BMI categories and BMI trajectories were longitudinally associated with frailty in older adults via systematic review and meta-analysis of prospective cohort studies.
METHODS: 3 databases (PubMed/MEDLINE, EMBASE and Web of Science) were systematically searched from inception to 8 September 2023. Two independent reviewers extracted data and appraised study quality. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Data were pooled using random-effects models.
RESULTS: 7 prospective cohort studies with 23043 participants were included in final BMI categories analyses, and 3 studies included BMI trajectory(23725 individuals). Compared with normal weight, we found a positive association between obesity (odds ratios(OR) = 1.74, 95 % confidence interval (CI): 1.21-2.51, P = 0.003), underweight (OR = 1.70, 95 % CI: 1.13-2.57, P = 0.011) and frailty in older adults. In middle age subgroup, compared with normal weight, OR of 2.21 (95 % CI: 1.44-3.38;I2 = 0 %) for overweight and OR of 5.20 (95 % CI: 2.56-10.55; I2 = 0 %) for obesity were significantly associated with frailty. In old age subgroup, compared with normal weight, only OR of 1.41 (95 % CI: 1.13-1.77; I2 = 65 %) for obesity was significantly associated with frailty. The results of BMI trajectories found that decreasing BMI (OR = 3.25, 95 % CI: 2.20-4.79, P < 0.0001) and consistently high BMI (OR = 3.66, 95 % CI: 2.03-6.61, P < 0.0001) increase the risk of frailty compared to consistently normal or overweight.
CONCLUSIONS: Overweight and obesity in middle age were associated with significantly higher frailty in older adults, while obesity and underweight in old age were associated with relatively higher frailty in older adults. Early weight control may be beneficial for old age.
METHODS: 3 databases (PubMed/MEDLINE, EMBASE and Web of Science) were systematically searched from inception to 8 September 2023. Two independent reviewers extracted data and appraised study quality. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Data were pooled using random-effects models.
RESULTS: 7 prospective cohort studies with 23043 participants were included in final BMI categories analyses, and 3 studies included BMI trajectory(23725 individuals). Compared with normal weight, we found a positive association between obesity (odds ratios(OR) = 1.74, 95 % confidence interval (CI): 1.21-2.51, P = 0.003), underweight (OR = 1.70, 95 % CI: 1.13-2.57, P = 0.011) and frailty in older adults. In middle age subgroup, compared with normal weight, OR of 2.21 (95 % CI: 1.44-3.38;I2 = 0 %) for overweight and OR of 5.20 (95 % CI: 2.56-10.55; I2 = 0 %) for obesity were significantly associated with frailty. In old age subgroup, compared with normal weight, only OR of 1.41 (95 % CI: 1.13-1.77; I2 = 65 %) for obesity was significantly associated with frailty. The results of BMI trajectories found that decreasing BMI (OR = 3.25, 95 % CI: 2.20-4.79, P < 0.0001) and consistently high BMI (OR = 3.66, 95 % CI: 2.03-6.61, P < 0.0001) increase the risk of frailty compared to consistently normal or overweight.
CONCLUSIONS: Overweight and obesity in middle age were associated with significantly higher frailty in older adults, while obesity and underweight in old age were associated with relatively higher frailty in older adults. Early weight control may be beneficial for old age.
摘要：
目的：我们旨在通过前瞻性队列研究的系统评价和荟萃分析，确定BMI类别和BMI轨迹是否与老年人的虚弱纵向相关。
方法：3个数据库（PubMed/MEDLINE，EMBASE和WebofScience)从成立到2023年9月8日进行了系统搜索。两名独立评审员提取数据并评估研究质量。使用纽卡斯尔-渥太华量表评估研究的质量。使用随机效应模型汇集数据。
结果：7个前瞻性队列研究纳入了23043名参与者的最终BMI类别分析，3项研究包括BMI轨迹(23725人)。与正常体重相比，我们发现肥胖之间存在正相关（优势比（OR）=1.74，95％置信区间（CI）：1.21-2.51，P=0.003），老年人体重不足(OR=1.70,95%CI:1.13-2.57,P=0.011)和虚弱。在中年亚组，与正常体重相比，超重的OR为2.21（95％CI：1.44-3.38；I2=0％），肥胖的OR为5.20（95％CI：2.56-10.55；I2=0％）与虚弱显着相关。在老年亚组中，与正常体重相比，肥胖仅OR为1.41(95%CI:1.13~1.77;I2=65%)与虚弱显著相关.BMI轨迹的结果发现，与持续正常或超重相比，BMI降低（OR=3.25，95％CI：2.20-4.79，P<0.0001）和持续高BMI（OR=3.66，95％CI：2.03-6.61，P<0.0001）增加了虚弱的风险。
结论：中年人的超重和肥胖与老年人的虚弱程度显著相关，而老年人的肥胖和体重不足与相对较高的虚弱有关。早期控制体重可能对老年有益。
方法：3个数据库（PubMed/MEDLINE，EMBASE和WebofScience)从成立到2023年9月8日进行了系统搜索。两名独立评审员提取数据并评估研究质量。使用纽卡斯尔-渥太华量表评估研究的质量。使用随机效应模型汇集数据。
结果：7个前瞻性队列研究纳入了23043名参与者的最终BMI类别分析，3项研究包括BMI轨迹(23725人)。与正常体重相比，我们发现肥胖之间存在正相关（优势比（OR）=1.74，95％置信区间（CI）：1.21-2.51，P=0.003），老年人体重不足(OR=1.70,95%CI:1.13-2.57,P=0.011)和虚弱。在中年亚组，与正常体重相比，超重的OR为2.21（95％CI：1.44-3.38；I2=0％），肥胖的OR为5.20（95％CI：2.56-10.55；I2=0％）与虚弱显着相关。在老年亚组中，与正常体重相比，肥胖仅OR为1.41(95%CI:1.13~1.77;I2=65%)与虚弱显著相关.BMI轨迹的结果发现，与持续正常或超重相比，BMI降低（OR=3.25，95％CI：2.20-4.79，P<0.0001）和持续高BMI（OR=3.66，95％CI：2.03-6.61，P<0.0001）增加了虚弱的风险。
结论：中年人的超重和肥胖与老年人的虚弱程度显著相关，而老年人的肥胖和体重不足与相对较高的虚弱有关。早期控制体重可能对老年有益。
