Abstract
OBJECTIVES: To examine the association between the use of compensatory strategies to successfully complete common daily activities-an indicator of pre-clinical disability-and body mass in pre-clinically disabled older adults. DESIGN: Cross-sectional observational study. PARTICIPANTS: Two hundred and fifty-nine pre-clinically disabled older adults defined as having changed the frequency or manner of performing daily tasks without reporting any difficulty. MEASUREMENTS: The use of compensatory strategies were objectively evaluated using the Modification (MOD) scale-a reliable and valid scale for assessing the manner in which common daily activities were completed. Height and weight were measured to classify participants into the following body mass index (BMI) categories: (1) normal: 18.5-24.9 kg/m(2), (2) overweight: 25.0-29.9 kg/m(2), (3) obese class I: 30.0-34.9 kg/m(2), and (4) obese class II: 35.0-39.9 kg/m(2). RESULTS: Compared to other BMI categories, individuals with class II obesity demonstrated a significantly higher probability of using ≥1 compensatory strategies when rising from a chair (30 cm height), kneel to stand, stair ascent, stair descent, and supine to stand tasks. When summarized over all tasks, individuals with class II obesity were 18 times more likely to use extensive compensatory strategies (≥6 on MOD scale) compared to normal weight older adults. Similar trends at a lesser magnitude were found in obese and overweight compared to normal weight older adults. CONCLUSION: Obesity is associated with extensive use of compensatory strategies when performing common daily tasks prior to the onset of perceived difficulty, thus placing them at higher risk of disability compared to their peers with lower body mass.