Obesity and Falls in a Prospective Study of Older Men: The Osteoporotic Fractures in Men Study
Abstract
Objective: The aim of this study is to evaluate fall rates across body mass index (BMI) categories by age group, considering physical performance and comorbidities. Method: In the Osteoporotic Fractures in Men (MrOS) study, 5,834 men aged ≥65 reported falls every 4 months over 4.8 (±0.8) years. Adjusted associations between BMI and an incident fall were tested using mixed-effects models. Results: The fall rate (0.66/man-year overall, 95% confidence interval [CI] = [0.65, 0.67]) was lowest in the youngest, normal weight men (0.44/man-year, 95% CI = [0.41, 0.47]) and greatest in the oldest, highest BMI men (1.47 falls/man-year, 95% CI = [1.22, 1.76]). Obesity was associated with a 24% to 92% increased fall risk in men below 80 (ptrend ≤ .0001, p for interaction by age = .03). Only adjustment for dynamic balance test altered the BMI–falls association substantially. Discussion: Obesity was independently associated with higher fall rates in men 65 to 80 years old. Narrow walk time, a measure of gait stability, may mediate the association.
Get full access to this article
View all access and purchase options for this article.
References
Almeida C. W., Castro C. H., Pedreira P. G., Heymann R. E., Szejnfeld V. L. (2011). Percentage height of center of mass is associated with the risk of falls among elderly women: A case-control study. Gait & Posture, 34, 208-212.
Barrett-Connor E., Edelstein S. L., Corey-Bloom J., Wiederholt W. C. (1996). Weight loss precedes dementia in community-dwelling older adults. Journal of the American Geriatrics Society, 44, 1147-1152.
Bassey E. J., Fiatarone M. A., O’Neill E. F., Kelly M., Evans W. J., Lipsitz L. A. (1992). Leg extensor power and functional performance in very old men and women. Clinical Science (London), 82, 321-327.
Bassey E. J., Short A. H. (1990). A new method for measuring power output in a single leg extension: Feasibility, reliability and validity. European Journal of Applied Physiology and Occupational Physiology, 60, 385-390.
Blank J. B., Cawthon P. M., Carrion-Petersen M. L., Harper L., Johnson J. P., Mitson E., Delay R. R. (2005). Overview of recruitment for the Osteoporotic Fractures in Men Study (MrOS). Contemporary Clinical Trials, 26, 557-568.
Capodaglio P., Castelnuovo G., Brunani A., Vismara L., Villa V., Capodaglio E. M. (2010). Functional limitations and occupational issues in obesity: A review. International Journal of Occupational Safety and Ergonomics, 16, 507-523.
Clark D. J. (2015). Automaticity of walking: Functional significance, mechanisms, measurement and rehabilitation strategies. Frontiers in Human Neuroscience, 9, Article 246.
Corbeil P., Simoneau M., Rancourt D., Tremblay A., Teasdale N. (2001). Increased risk for falling associated with obesity: Mathematical modeling of postural control. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 9, 126-136.
Cummings S. R., Nevitt M. C., Kidd S. (1988). Forgetting falls. The limited accuracy of recall of falls in the elderly. Journal of the American Geriatrics Society, 36, 613-616.
Ensrud K. E., Ewing S. K., Stone K. L., Cauley J. A., Bowman P. J., Cummings S. R. Study of Osteoporotic Fractures Research Group. (2003). Intentional and unintentional weight loss increase bone loss and hip fracture risk in older women. Journal of the American Geriatrics Society, 51, 1740-1747.
Faulkner K. A., Cauley J. A., Zmuda J. M., Landsittel D. P., Nevitt M. C., Newman A. B., … Redfern M. S. (2005). Ethnic differences in the frequency and circumstances of falling in older community-dwelling women. Journal of the American Geriatrics Society, 53, 1774-1779.
Fjeldstad C., Fjeldstad A. S., Acree L. S., Nickel K. J., Gardner A. W. (2008). The influence of obesity on falls and quality of life. Dynamic Medicine, 7, Article 4.
Hannan M. T., Gagnon M. M., Aneja J., Jones R. N., Cupples L. A., Lipsitz L. A., … Kiel D. P. (2010). Optimizing the tracking of falls in studies of older participants: Comparison of quarterly telephone recall with monthly falls calendars in the MOBILIZE Boston Study. American Journal of Epidemiology, 171, 1031-1036.
Himes C. L., Reynolds S. L. (2012). Effect of obesity on falls, injury, and disability. Journal of the American Geriatrics Society, 60, 124-129.
Hita-Contreras F., Martinez-Amat A., Lomas-Vega R., Alvarez P., Mendoza N., Romero-Franco N., Aranega A. (2013). Relationship of body mass index and body fat distribution with postural balance and risk of falls in Spanish postmenopausal women. Menopause, 20, 202-208.
Kelsey J. L., Procter-Gray E., Hannan M. T., Li W. (2012). Heterogeneity of falls among older adults: Implications for public health prevention. American Journal of Public Health, 102, 2149-2156.
Lee C. G., Boyko E. J., Nielson C. M., Stefanick M. L., Bauer D. C., Hoffman A. R. . . . Osteoporotic Fractures in Men Study Group. (2011). Mortality risk in older men associated with changes in weight, lean mass, and fat mass. Journal of the American Geriatrics Society, 59, 233-240.
Lo A. X., Brown C. J., Sawyer P., Kennedy R. E., Allman R. M. (2014). Life-space mobility declines associated with incident falls and fractures. Journal of the American Geriatrics Society, 62, 919-923.
Lord S. R., Menz H. B., Tiedemann A. (2003). A physiological profile approach to falls risk assessment and prevention. Physical Therapy, 83, 237-252.
Maffiuletti N. A., Agosti F., Proietti M., Riva D., Resnik M., Lafortuna C. L., Sartorio A. (2005). Postural instability of extremely obese individuals improves after a body weight reduction program entailing specific balance training. Journal of Endocrinological Investigation, 28, 2-7.
Maurer M. S., Burcham J., Cheng H. (2005). Diabetes mellitus is associated with an increased risk of falls in elderly residents of a long-term care facility. The Journals of Gerontology, Series A: Biological Sciences & Medical Sciences, 60, 1157-1162.
Mignardot J. B., Olivier I., Promayon E., Nougier V. (2010). Obesity impact on the attentional cost for controlling posture. PLoS ONE, 5(12), e14387.
Mitchell R. J., Lord S. R., Harvey L. A., Close J. C. (2014). Associations between obesity and overweight and fall risk, health status and quality of life in older people. Australian and New Zealand Journal of Public Health, 38, 13-18.
Mitchell R. J., Lord S. R., Harvey L. A., Close J. C. (2015). Obesity and falls in older people: Mediating effects of disease, sedentary behavior, mood, pain and medication use. Archives of Gerontology and Geriatrics, 60, 52-58.
Mokdad A. H., Serdula M. K., Dietz W. H., Bowman B. A., Marks J. S., Koplan J. P. (1999). The spread of the obesity epidemic in the United States, 1991-1998. Journal of the American Medical Association, 282, 1519-1522.
Nevitt M. C., Cummings S. R., Kidd S., Black D. (1989). Risk factors for recurrent nonsyncopal falls. A prospective study. Journal of the American Medical Association, 261, 2663-2668.
Ogden C. L., Carroll M. D., Kit B. K., Flegal K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association, 311, 806-814.
Orwoll E., Blank J. B., Barrett-Connor E., Cauley J., Cummings S., Ensrud K., … Stone K. (2005). Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—A large observational study of the determinants of fracture in older men. Contemporary Clinical Trials, 26, 569-585.
Pahor M., Chrischilles E. A., Guralnik J. M., Brown S. L., Wallace R. B., Carbonin P. (1994). Drug data coding and analysis in epidemiologic studies. European Journal of Epidemiology, 10, 405-411.
Pahor M., Guralnik J. M., Ambrosius W. T., Blair S., Bonds D. E., Church T. S. . . . LIFE Study Investigators. (2014). Effect of structured physical activity on prevention of major mobility disability in older adults: The LIFE study randomized clinical trial. Journal of the American Medical Association, 311, 2387-2396.
Rejeski W. J., Axtell R., Fielding R., Katula J., King A. C., Manini T. M. . . . LIFE Study Investigator Group. (2013). Promoting physical activity for elders with compromised function: The lifestyle interventions and independence for elders (LIFE) study physical activity intervention. Clinical Interventions in Aging, 8, 1119-1131.
Ren J., Waclawczyk A., Hartfield D., Yu S., Kuang X., Zhang H., Alamgir H. (2014). Analysis of fall injuries by body mass index. Southern Medical Journal, 107, 294-300.
Rubenstein L. Z. (2006). Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing, 35(Suppl. 2), ii37-ii41.
Seeman T. E., Charpentier P. A., Berkman L. F., Tinetti M. E., Guralnik J. M., Albert M., … Rowe J. W. (1994). Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging. Journal of Gerontology, 49(3), M97-M108.
Simpson L. A., Miller W. C., Eng J. J. (2011). Effect of stroke on fall rate, location and predictors: A prospective comparison of older adults with and without stroke. PLoS ONE, 6(4), e19431.
Siqueira F. V., Facchini L. A., Silveira D. S., Piccini R. X., Tomasi E., Thume E., … Dilelio A. (2011). Prevalence of falls in elderly in Brazil: A countrywide analysis. Cadernos de Saúde Pública, 27, 1819-1826.
Sparling P. B., Howard B. J., Dunstan D. W., Owen N. (2015). Recommendations for physical activity in older adults. British Medical Journal, 350, Article h100.
Stevens J. A., Mack K. A., Paulozzi L. J., Ballesteros M. F. (2008). Self-reported falls and fall-related injuries among persons aged ≥65 years—United States, 2006. Journal of Safety Research, 39, 345-349.
Sturnieks D. L., Tiedemann A., Chapman K., Munro B., Murray S. M., Lord S. R. (2004). Physiological risk factors for falls in older people with lower limb arthritis. The Journal of Rheumatology, 31, 2272-2279.
Tinetti M. E., Speechley M., Ginter S. F. (1988). Risk factors for falls among elderly persons living in the community. The New England Journal of Medicine, 319, 1701-1707.
Villareal D. T., Chode S., Parimi N., Sinacore D. R., Hilton T., Armamento-Villareal R., … Shah K. (2011). Weight loss, exercise, or both and physical function in obese older adults. The New England Journal of Medicine, 364, 1218-1229.
Villareal D. T., Shah K., Banks M. R., Sinacore D. R., Klein S. (2008). Effect of weight loss and exercise therapy on bone metabolism and mass in obese older adults: A one-year randomized controlled trial. The Journal of Clinical Endocrinology & Metabolism, 93, 2181-2187.
Wallace J. I., Schwartz R. S., LaCroix A. Z., Uhlmann R. F., Pearlman R. A. (1995). Involuntary weight loss in older outpatients: Incidence and clinical significance. Journal of the American Geriatrics Society, 43, 329-337.
Washburn R. A., McAuley E., Katula J., Mihalko S. L., Boileau R. A. (1999). The Physical Activity Scale for the Elderly (PASE): Evidence for validity. Journal of Clinical Epidemiology, 52, 643-651.
Washburn R. A., Smith K. W., Jette A. M., Janney C. A. (1993). The Physical Activity Scale for the Elderly (PASE): Development and evaluation. Journal of Clinical Epidemiology, 46, 153-162.
Cite article
Cite article
Cite article
OR
Download to reference manager
If you have citation software installed, you can download article citation data to the citation manager of your choice
Information, rights and permissions
Information
Published In
Article first published online: July 27, 2016
Issue published: October 2017
Keywords
PubMed: 27469600
Authors
Metrics and citations
Metrics
Journals metrics
This article was published in Journal of Aging and Health.
VIEW ALL JOURNAL METRICSArticle usage*
Total views and downloads: 465
*Article usage tracking started in December 2016
Articles citing this one
Receive email alerts when this article is cited
Web of Science: 14 view articles Opens in new tab
Crossref: 12
- Role of Perceived Physical and Mental Fatigability Severity on Prospec...
- Bone Response to Weight Loss Following Bariatric Surgery
- Association between body mass index and falls in community-dwelling me...
- Association Between Body Mass Index and Functional Outcomes in Elderly...
- Positive correlations between physical activity level and composite in...
- Body mass index and risk of recurrent falls in community‐dwelling Japa...
- Falls, fractures, and areal bone mineral density in older adults with ...
- Higher Fatigue Prospectively Increases the Risk of Falls in Older Men
- Adjustment of DXA BMD measurements for anthropometric factors and its ...
- Does Obesity Increase the Risk and Severity of Falls in People Aged 60...
- Age modify the associations of obesity, physical activity, vision and ...
- Obesity is associated with reduced postural control in community-dwell...
Figures and tables
Figures & Media
Tables
View Options
Get access
Access options
If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:
loading institutional access options
Alternatively, view purchase options below:
Purchase 24 hour online access to view and download content.
Access journal content via a DeepDyve subscription or find out more about this option.
