Does Obesity Increase the Risk and Severity of Falls in People Aged 60 Years and Older? A Systematic Review and Meta-analysis of Observational Studies

Abstract

Background Recent investigations suggest that obesity may be associated with an increased risk of falls; however, this theory has yet to be definitively confirmed. This systematic review and meta-analysis examined the strength of the association between obesity and falls, multiple falls, fall-related injuries, and fall-related fractures among older adults. Methods MEDLINE, Embase, CINAHL, PsycINFO, SPORTDiscus, LILACS, and Web of Science databases were searched to identify observational studies that assessed the association between obesity and fall-related outcomes in participants aged 60 years and older. Two independent reviewers performed data extraction and quality assessment. Relative risks and 95% confidence intervals (CI) were pooled using random effect meta-analyses. Results Thirty-one studies including a total of 1,758,694 participants were selected from 7,815 references. Pooled estimates showed that obese older adults have an increased risk of falls compared with nonobese counterparts (24 studies; relative risk: 1.16; 95% CI: 1.07–1.26; I2: 90%). Obesity was also associated with an increased risk of multiple falls (four studies; relative risk: 1.18; 95% CI: 1.08–1.29; I2: 0%). There was no evidence, however, of an association between obesity and fall-related injuries (seven studies; relative risk: 1.04; 95% CI: 0.92–1.18; I2: 65%). Fall-related fractures were reported in only one study, which demonstrated a lower risk of hip fracture with obesity (odds ratio: 0.65; 95% CI: 0.63–0.68). Conclusions Obesity increases the risk of falls and multiple falls in people aged 60 years and older; however, there is insufficient evidence of an association with fall-related injuries or fractures. Prevention and treatment of obesity may play a role in preventing falls in older age.

Age-Related Skeletal Muscle Dysfunction Is Aggravated by Obesity: An Investigation of Contractile Function, Implications and Treatment

“…Compared to normal-weight counterparts, old obese individuals may be at greater risk of musculoskeletal injury given the importance of adequate muscle function for maintaining joint stability and absorbing impact forces [ 135 , 136 , 137 ]. For example, old obese individuals have greater fall risk [ 138 , 139 ], with muscular strength recognised as an important facet of postural control [ 140 , 141 ]. Furthermore, the impact of musculoskeletal injury may be more severe in old obese adults, as discussed in more detail below.…”

Identification of risk factors for falls in postmenopausal women: a systematic review and meta-analysis

“…The meta-analysis showed that older age is a risk factor for falls, and the statistical results are stable and reliable. During menopause, women's hormone levels decrease each year, and their physical function declines more rapidly than that of men [30,31]. Therefore, as menopausal women grow older, their physical functions, muscle functions and stability may weaken, thus increasing the risk of falling.…”

Epidemiological Comparison of Osteoporotic Hip Fractures in Spain and China: A Multicenter Study

“…However, from the study we conducted, the percentage of overweight and obese patients with hip fractures in Spain is close to 60%, which is signi cantly higher than the percentage in the normal population [19]. Perhaps this is because obese patients do not have much exibility, are more likely to fall, and the excessive weight at the time of injury exerts more force, which offsets the better bone density [20,21]. In addition, it is well known that obesity is also a risk factor for many diseases, such as cardiovascular and cerebrovascular diseases, diabetes, and arthritis [22].…”