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Central obesity raises fall risk in older adults with normal weight

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February 14, 2018

Older adults of normal weight but with central obesity are nearly twice as likely to experience a fall during a 2-year period than adults with obesity but without central obesity, according to findings published in the American Journal of Preventive Medicine.

“Using BMI alone cannot fully detect health risks related to excess body weight,” Beom-Young Cho, PhD, of the department of psychology at Colorado State University, and colleagues wrote. “[Community-dwelling older adults] who are not obese by BMI category but are [centrally obese] based on waist circumference may be excluded from the population considered most susceptible to falls and possibly other obesity-related problems, when they actually should be a focus of health professionals who provide fall prevention screening and programming.”

Cho and colleagues analyzed data from 3,383 adults aged at least 65 years who participated in the 2012 and 2014 Health and Retirement Study, a longitudinal assessment of health, work, retirement and family characteristics funded by the National Institute of Aging (1,979 women). Participants were classified as having normal weight (BMI < 25 kg/m²), overweight (BMI 25-30 kg/m²) or obesity (BMI 30 kg/m²) and were stratified by central obesity status, defined as a waist circumference at least 102 cm for men and 88 cm for women. Researchers used logistic regression analysis to examine the associations between BMI category and central obesity status and experiencing a fall, as well as the associations between BMI category and central obesity status with the number of falls.

Within the cohort, 35.9% had overweight and 39.5% had obesity, whereas 65.1% had central obesity. Among adults with normal BMI, 17.4% had central obesity. Researchers observed an average of 1.06 falls among all participants, with 35.2% of participants reporting at least one fall in the past 2 years, and 31.7% of those who fell were injured seriously enough to require medical treatment.

Researchers found that older adults with normal weight but with central obesity reported the highest incidence of falls (47%), followed by older adults with both obesity and central obesity (36.8%). Adults with obesity but without central obesity had the lowest fall incidence (24.6%).

Compared with adults who do not have central obesity, those with central obesity were more likely to experience a fall (adjusted OR = 1.37; 95% CI, 1.01-1.85) and experienced more falls in the past 2 years (incidence rate ratio = 1.15; 95% CI, 1.03-1.29), with results persisting after adjustment for BMI and other risk factors. Additionally, fallers with obesity were less likely to experience a fall-related injury vs. normal-weight adults who fell (aOR = 0.56; 95% CI, 0.35-0.91).

The researchers noted that individuals with central obesity, or an “apple-shaped” body type, have a higher center of gravity than individuals without central obesity, or a “pear-shaped” body type, and normal-weight individuals.

“In addition, [centrally obese] individuals have more pronounced lumbar lordosis that causes an abnormally forwarded or anteriorly shifted center of gravity compared with individuals without [central obesity],” the researchers wrote. “Because a higher center of gravity and an off-centered line of gravity are correlated with poor posture stability, which is a significant risk factor for falls among older adults, [centrally obese] older adults may have a higher risk for falls than their counterparts.” – by Regina Schaffer

Disclosure s : The authors report no relevant financial disclosures.