Comparison of novel and traditional anthropometric indices: which is the best indicator of frailty in older adults?

Sep 30, 2026

Upload by Rowan

Frailty is a critical geriatric syndrome linked to adverse outcomes and characterized by a complex relationship with obesity. Traditional anthropometric measures, including body mass index (BMI), inadequately capture obesity-related risks in older populations. Novel indices may better reflect visceral adiposity and improve frailty prediction. This study evaluates how BMI, BRI, ABSI, WHtR, and WHT·5R associate with frailty severity in older adults using NHANES data.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Keywords

Introduction

Aging Clinical and Experimental Research (2026) 38:37 [https://doi.org/10.1007/s40520-025-03293-0](https://doi.org/10.1007/s40520-025-03293-0) RESEARCH Comparison of novel and traditional anthropometric indices: which is the best indicator of frailty in older adults? Aijun Song1 · Siying Yu2 · Taotao Huang1 · Jian Shi3 Received: 26 May 2025 / Revised: 22 November 2025 / Accepted: 8 December 2025 © The Author(s) 2025 Abstract Background Frailty is a critical geriatric syndrome associated with adverse health outcomes and exhibits a complex relationship with obesity. Traditional anthropometrics, such as body mass index (BMI), inadequately assess obesity-related risks in the aging population. Emerging indices better capture visceral adiposity, potentially enhancing frailty prediction. This study evaluates these indices’ associations with frailty in older adults. Methods This study analyzed existing data collected between 2002 and 2007 as part of the National Health and Nutrition Examination Survey (NHANES) . BMI, body roundness index (BRI), a body shape index (ABSI), waist-to-height ratio (WHtR), and waist/height0.5 (WHT·5R) were calculated using waist circumference, weight, and height. We used a modified frailty index (FI) with 36 standardized parameters to quantify the severity of frailty by the cumulative proportion of deficits. Results In the adjusted model, increases in all indices except ABSI were statistically significantly associated with increases in FI (BRI: β(95%CI) = 0.004(0.003, 0.005); BMI: β(95%CI) = 0.001(0.0001, 0.001); ABSI: β(95%CI) = 2.034(1.627, 2.440); WHtR: β(95%CI) = 0.093(0.067, 0.119); WHT·5R: β(95%CI) = 0.007(0.005,0.009)) . Bootstrap analysis showed that BRI had a greater impact on FI than BMI (difference = 0.0019), while WHtR and WHT·5R had a stronger impact on FI than BRI (difference = −0.0746 and −0.0027, respectively) . The effect of WHtR on FI was significantly higher than that ofWHT·5R (difference = 0.0719) . Conclusion This study highlighted that WHtR was more strongly associated with FI than BMI, BRI, and WHT·5R, and highlighted the priority of waist-centered obesity measures in frailty risk assessment and clinical intervention in the elderly. Keywords Frailty · Older adults · Anthropometric indices · Obesity · NHANES Introduction Frailty, a complex geriatric syndrome marked by reduced physiological reserve and increased susceptibility to stress, has grown into a significant public health issue in older Aijun Song and Siying Yu have contributed equally to this work and share first authorship. 􀀍 Jian Shi [shijian@whu.edu.cn](shijian@whu.edu.cn) 1 Department of Surgery, Jiaozuo People’s Hospital, Jiaozuo 454000, China 2 Department of Cardiology, Fuwai Shenzhen Hospital, Chinese Academy of Medical Sciences, Shenzhen 518052, China 3 Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430000, China adults [1] . Frailty occurs when individuals are unable to withstand multiple stressors, or stressors like healthy individuals, resulting in imbalances in the regulation of multiple physiological processes. Frailty is linked to a higher prevalence of negative health outcomes, encompassing, but not restricted to, mortality, disability, and depression [2, 3] . With the global population of older adults projected to double by 2050, identifying modifiable risk factors and early predictors of frailty has become a public health imperative [4] . Obesity affects over 40% of older adults in highincome countries and presents a paradoxical relationship with frailty [5] . Increasing evidence demonstrates that obesity elevates frailty risk [5, 6], challenging the traditional characterization of frailty as a “wasting disorder”. Adipose tissue-driven chronic inflammation, insulin resistance, and sarcopenic obesity may accelerate frailty pathogenesis [7] . Anthropometric indices, such as body mass index (BMI), body roundness index (BRI), a body s

FAQs

Why are traditional anthropometric measures like BMI insufficient for frailty risk assessment?

BMI is a general proxy for excess adiposity, but it does not distinguish fat versus lean tissue or capture central versus peripheral fat distribution, limiting its ability to reflect obesity-related frailty risks in older adults.

Which anthropometric indices were compared in the study?

The study calculated BMI, body roundness index (BRI), body shape index (ABSI), waist-to-height ratio (WHtR), and waist/height0.5 (WHT·5R) using waist circumference, weight, and height.

What was the main finding regarding the strongest association with frailty?

In adjusted analyses, WHtR showed a stronger association with the modified frailty index than BMI, BRI, and WHT·5R, supporting waist-centered obesity measures as priorities for frailty risk assessment and clinical intervention.

Sep 30, 2026

Upload by Rowan