Mixed
In very old adults (72-95 years), high percent body fat is strongly associated with physical disability, whereas low skeletal muscle mass is not associated with disability.
For adults over 70, maintaining a healthy body fat percentage appears to be more critical for preventing physical disability than simply having high muscle mass. While resistance training is beneficial, excessive fat accumulation significantly increases the risk of disability, likely due to mechanical burden and chronic disease links. Focus on body composition (reducing fat) rather than just muscle size.
In contrast to current assumptions, low skeletal muscle mass was not associated with self-reported physical disability. Persons with a high percent body fat had high levels of disability.
Why this rating
Large cohort (n=753), rigorous DXA measurement, adjusted for many confounders, but limited by cross-sectional design preventing causal inference.
Source
Body Fat and Skeletal Muscle Mass in Relation to Physical Disability in Very Old Men and Women of the Framingham Heart Study
Marjolein Visser et al. · The Journals of Gerontology Series A · 1998
DOI 10.1093/gerona/53a.3.m214
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