Association of dynapenia, obesity and chronic diseases with all-cause mortality of community-dwelling older adults: A path analysis

Aim The objective of the present study was to evaluate the effect of dynapenia, central obesity and the presence of chronic diseases in 8-year mortality of community-dwelling older adults. Methods Participants comprised 610 older adults, aged >= 65 years at baseline, who participated in the Frailty in Brazilian Older People study carried out in 2008. Baseline data, such as weight, height, waist circumference, muscle strength, sex, self-reported diseases and physical activity, were assessed. Vital status in 2016 was assessed by Mortality Information System database of Campinas. The chi(2)-test and Mann-Whitney U-test were used to compare categorical and continuous variables, respectively. Path analysis was carried out to study the factors associated with mortality. Results There was a statistical difference between alive and deceased groups for the variables sex, age group, physical activity, waist circumference and dynapenia. Path analysis explored the relationship among the studied variables. Direct paths showed a positive association to mortality for those who presented the combination of more diseases (beta = 0.105), male sex (beta = 0.108), low physical activity (beta = 0.121), low handgrip strength (beta = 0.090) and no central obesity (beta = -0.143). When indirect paths were concerned, variables central obesity, the presence of more diseases and dynapenia had a mediator role. Conclusions Central obesity was not positively associated with higher mortality, unless it was associated with the presence of chronic diseases. Dynapenia showed a direct effect on mortality, but not combined with central obesity. The findings of this study shed light on complex relationships between nutritional status and elderly mortality through the use of simple measurements. Geriatr Gerontol Int 2019; 19: 108-112.