Association Between Life‐Course Obesity and Frailty in Older Adults: Findings in the GAZEL Cohort

Objective This study aimed to assess the relationship between weight history during adulthood and frailty in late life in men and women participating in the GAZEL (GAZ and ELectricité) cohort. Methods This cohort study included 8,751 men and 3,033 women (aged 61 to 76 years) followed up since 1989. Modified Fried’s frailty criteria (weakness, fatigue, unintentional weight loss, low physical activity, and impaired mobility) were assessed in 2015. Reported BMI was determined each year to characterize: obesity status in 2015, obesity duration over the 1990 to 2015 period, and trajectories of BMI. Associations between frailty and weight history were assessed using multinomial regression. Results In 2015, 12% of men had obesity, 1.8% severe obesity, and 0.4% morbid obesity; for women, these percentages were 11%, 2.2%, and 0.8%, respectively. Individuals with obesity were more likely to be frail than those with normal BMI and the risk of frailty increased with each additional year of obesity (adjusted odds ratio 1.04 [1.00–1.08] for men and 1.07 [1.02–1.13] for women). Trajectories of BMI revealed that both long‐term obesity and onset of obesity in late adulthood were associated with frailty. Conclusions Current and past obesity appear to be important determinants of frailty. Early weight management may be beneficial in old age.