Dynapenic abdominal obesity and the incidence of falls in older women: a prospective study
Dynapenic abdominal obesity (D/AO) has been associated with negative outcomes in older people, including trait of falls.
To assess the association between D/AO and the incidence of falls over 18 months in older community-dwelling women.
A total of 201 older women (67.97 ± 6.02 years; 27.70 kg/m2) underwent waist circumference measurement, and had handgrip strength assessed using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength, while abdominal obesity was considered as a waist circumference > 88 cm. D/AO was the combination of both aforementioned criteria. Volunteers were classified into four groups: normal, abdominal obesity, dynapenic, and D/AO. Participants were then tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and multivariable Cox proportional regressions were conducted.
The overall incidence of falls over the follow-up was 27.5%; and for normal, dynapenic, abdominal obesity, and D/AO were 14.7%, 17.2%, 27.5%, and 40.4% (X2 = 8.341; P = 0.039), respectively. D/AO was associated with a higher risk of falls (hazard ratio: 3.595 [95% CI: 1.317–9.815], even after adjustments for age, body mass index, physical activity level, regular use of medications, peripheral sensation, chronic diseases, and history of lower-limbs pain.
D/AO is more closely related to falls than either dynapenia or abdominal obesity alone, and is independently associated with an increased incidence of falls in older women. These results provide support for the concept that the combined evaluation of muscle strength and central obesity may be clinically relevant in this population.
KeywordsObesity Sarcopenia Accidental falls Muscle strength Hand strength
The authors would like to thank the Brazilian Coordination for the Improvement of Higher Education Personnel (CAPES) and National Council for Scientific and Technological Development (CNPq).
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Statement of human and animal rights
All experiments on human subjects were conducted in accordance with the Declaration of Helsinki and the study protocol was previously approved by the Institutional Review Board (1.2223.636).
All volunteers were informed about the study procedures and voluntarily signed an informed consent form.
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