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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Inouye SK, Studenski S, Tinetti ME et al (2007) Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc 55:780–791
Gelbard R, Inaba K, Okoye OT et al (2014) Falls in the elderly: a modern look at an old problem. Am J Surg 208:249–253
Query W-bIS (2016) Reporting System (WISQARS). Centers for Disease Control and Prevention. National Center for Injury Prevention and Control
Gazibara T, Kurtagic I, Kisic-Tepavcevic D et al (2017) Falls, risk factors and fear of falling among persons older than 65 years of age. Psychogeriatrics 17:215–223
Enderlin C, Rooker J, Ball S et al (2015) Summary of factors contributing to falls in older adults and nursing implications. Geriatr Nurs 36:397–406
Cruz-Jentoft AJ, Bahat G, Bauer J et al (2018) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48:16–31
Gadelha AB, Paiva FML, Gauche R et al (2016) Effects of resistance training on sarcopenic obesity index in older women: a randomized controlled trial. Arch Gerontol Geriatr 65:168–173
Jarosz PA, Bellar A (2009) Sarcopenic obesity: an emerging cause of frailty in older adults. Geriatr Nurs 30:64–70
Chang C-I, Huang K-C, Chan D-C et al (2015) The impacts of sarcopenia and obesity on physical performance in the elderly. Obes Res Clin Pract 9:256–265
Goodpaster BH, Chomentowski P, Ward BK et al (2008) Effects of physical activity on strength and skeletal muscle fat infiltration in older adults: a randomized controlled trial. J Appl Physiol 105:1498–1503. https://doi.org/10.1152/japplphysiol.90425.2008
Frontera WR, Hughes VA, Fielding RA et al (2000) Aging of skeletal muscle: a 12-yr longitudinal study. J Appl Physiol 88:1321–1326
PicciniI RX, TomasiI E, ThuméI E et al (2007) Prevalência de quedas em idosos e fatores associados. Rev Saude Publica 41:749–756
Newman AB, Kupelian V, Visser M et al (2003) Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 51:1602–1609
Visser M, Goodpaster BH, Kritchevsky SB et al (2005) Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol Ser A Biol Sci Med Sci 60:324–333
Barbat-Artigas S, Rolland Y, Cesari M et al (2012) Clinical relevance of different muscle strength indexes and functional impairment in women aged 75 years and older. J Gerontol Ser A Biomed Sci Med Sci 68:811–819
Menant J, Weber F, Lo J et al (2017) Strength measures are better than muscle mass measures in predicting health-related outcomes in older people: time to abandon the term sarcopenia? Osteoporos Int 28:59–70
Pereira JC, de Moraes Elias J, Neri SG et al (2019) Dynapenic abdominal obesity as a risk factor for falls in older women. Top Geriatr Rehabilit 35:149–155
Máximo RDO, Santos JLF, Perracini MR et al (2018) Abdominal obesity, dynapenia and dynapenic-abdominal obesity as factors associated with falls: dynapenic obesity and falls. Braz J Phys Ther. https://doi.org/10.1016/j.bjpt.2018.10.009
Alexandre TdS, Scholes S, Santos JLF et al (2018) Dynapenic abdominal obesity as a risk factor for worse trajectories of ADL disability among older adults: ELSA cohort study. J Gerontol Ser A 74:1112–1118
Neri SGR, Gadelha AB, de David AC et al (2017) The association between body adiposity measures, postural balance, fear of falling, and fall risk in older community-dwelling women. J Geriatr Phys Ther. https://doi.org/10.1519/jpt.0000000000000165
Gadelha AB, Myers J, Moreira S et al (2016) Comparison of adiposity indices and cut-off values in the prediction of metabolic syndrome in postmenopausal women. Diabetes Metab Syndr 10:143–148
WHO (2015) World report on ageing and health. World Health Organization, Washington
Bouchard DR, Janssen I (2010) Dynapenic-obesity and physical function in older adults. J Gerontol Seri A Biol Sci Med Sci 65:71–77. https://doi.org/10.1093/gerona/glp159
Alberti K, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120:1640–1645
Rossi AP, Bianchi L, Volpato S et al (2017) Dynapenic abdominal obesity as a predictor of worsening disability, hospitalization, and mortality in older adults: results from the InCHIANTI study. J Gerontol Ser A Biomed Sci Med Sci 72:1098–1104
Craig CL, Marshall AL, Sjostrom M et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
Gadelha AB, Vainshelboim B, Ferreira AP et al (2018) Stages of sarcopenia and the incidence of falls in older women: a prospective study. Arch Gerontol Geriatr 79:151–157
Mathiowetz V, Weber K, Volland G et al (1984) Reliability and validity of grip and pinch strength evaluations. J Hand Surg 9:222–226
WHO (2011) Waist circumference and waist-hip ratio: report of a WHO expert consultation. WHO, Geneva
Barry E, Galvin R, Keogh C et al (2014) Is the timed up and go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr 14:14
Bernal RTI, Malta DC, Claro RM et al (2017) Efeito da inclusão de entrevistas por telefone celular ao Vigitel. Revista de Saúde Pública 51:15
Himes CL, Reynolds SL (2012) Effect of obesity on falls, injury, and disability. J Am Geriatr Soc 60:124–129
Mitchell RJ, Lord SR, Harvey LA et al (2014) Associations between obesity and overweight and fall risk, health status and quality of life in older people. Aust N Z J Public Health 38:13–18
Ylitalo KR, Karvonen-Gutierrez CA (2016) Body mass index, falls, and injurious falls among US adults: findings from the 2014 behavioral risk factor surveillance system. Prev Med 91:217–223
Cesari M, Landi F, Torre S et al (2002) Prevalence and risk factors for falls in an older community-dwelling population. J Gerontol Ser A Biol Sci Med Sci 57:M722–M726
Landi F, Liperoti R, Russo A et al (2012) Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr 31:652–658
Ko S-u, Jerome GJ, Simonsick EM et al (2018) Differential gait patterns by falls history and knee pain status in healthy older adults: results from the baltimore longitudinal study of aging. J Aging Phys Act 26:577–582
Cimas M, Ayala A, Sanz B et al (2018) Chronic musculoskeletal pain in European older adults: cross-national and gender differences. Eur J Pain 22:333–345
Tiedemann A, Lord SR, Sherrington C (2010) The development and validation of a brief performance-based fall risk assessment tool for use in primary care. J Gerontol Ser A Biol Sci Med Sci 65:896–903
Hairi NN, Cumming RG, Naganathan V et al (2010) Loss of muscle strength, mass (sarcopenia), and quality (specific force) and its relationship with functional limitation and physical disability: the concord health and ageing in men project. J Am Geriatr Soc 58:2055–2062
Bento PCB, Pereira G, Ugrinowitsch C et al (2010) Peak torque and rate of torque development in elderly with and without fall history. Clin Biomech 25:450–454
Lin S-I, Woollacott MH (2002) Postural muscle responses following changing balance threats in young, stable older, and unstable older adults. J Mot Behav 34:37–44
Simoneau M, Teasdale N (2015) Balance control impairment in obese individuals is caused by larger balance motor commands variability. Gait Posture 41:203–208
Tinetti ME, Kumar C (2010) The patient who falls:“It’s always a trade-off”. JAMA 303:258–266
Schaap LA, van Schoor NM, Lips P et al (2017) Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures; the longitudinal aging study Amsterdam. J Gerontol Ser A 73:1199–1204
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).
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.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Gadelha, A.B., Neri, S.G.R., Vainshelboim, B. et al. Dynapenic abdominal obesity and the incidence of falls in older women: a prospective study. Aging Clin Exp Res 32, 1263–1270 (2020). https://doi.org/10.1007/s40520-019-01318-z
- Accidental falls
- Muscle strength
- Hand strength