The role of waist circumference in predicting disability in periretirement age adults

Objective: To measure the risk of periretirement age disability associated with five different anthropometric measures of body mass and shape, and to compare the measures in this group, the peak age group of obesity prevalence. Design: Longitudinal study of Health Survey for England 1998 respondents followed-up in the English Longitudinal Study of Ageing in 2002. Subjects: National population sample of 1030 women and 888 men aged 55-74 years. Measurements: Five baseline exposure measures (weight (WT), body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR)) at baseline, and disability outcomes (measured gait speed, self-reported mobility problems, instrumental and ordinary activities of daily living (I/ADLs)) after 5 years. Results: Individually, the heaviest quartile of WC and WHR predicted disability using all outcomes in men. In women, the heaviest category of each of the five exposure measures predicted disability, for each of the outcomes. In competing measures models, WC was included in the best fit model of tested mobility disability in men (odds ratio (OR) 2.4; 95% confidence interval (CI) 1.4-4.1; P < 0.05) and women (OR 3.0; 95% CI 1.9-4.8; P < 0.001), adjusted for age, height, smoking, social class, and education. WC was also included in the best fit model of all self-reported disabilities in men, and for self-reported I/ADL disabilities in women. Conclusions: Across the periretirement age period, body mass and shape are major determinants of disability, with increases in WC, a marker for abdominal obesity, best predicting risk for most disability outcomes. This result adds to the case for WC to be used in estimates of obesity-related health risks for epidemiological monitoring and clinical care.