Protein Intake and Risk of Falls: A Prospective Analysis in Older Adults

Abstract

BACKGROUND The prospective association between protein intake and falls has been little studied. We assessed this association in a Spanish community‐dwelling cohort. METHODS We performed a prospective cohort study of 2464 men and women 60 years or older who were recruited in 2008‐2010 and followed up through 2012. At baseline, the habitual protein intake was determined with a validated dietary history. At the end of follow‐up, participants reported the number of falls experienced in the preceding year. Participants were stratified by an unintentional weight loss of 4.5 kg or more. Logistic regression was used after adjustment for the main confounders. RESULTS A total of 522 participants (21.2%) experienced at least one fall. The odds ratios (ORs) and 95% confidence intervals (CIs) of falling for the three increasing tertiles of total protein intake were 1.00, 0.86 (0.66‐1.11), and 0.93 (0.70‐1.24) (p for trend = 0.14). However, a statistically significant interaction with unintentional weight loss was observed for the association between protein intake and fall risk (p for interaction = 0.004). Among 163 participants (6.6%) who experienced unintentional weight loss, the ORs (95% CI) of falling for the three increasing tertiles of total protein intake were 1.00, 0.68 (0.21‐2.23), and 0.23 (0.05‐1.08) (p for trend = 0.01). CONCLUSION No protective association between protein intake and fall risk in older adults was found. However, high total protein intake tended to confer substantial benefits to participants who experienced an unintentional weight loss of 4.5 kg or more in the preceding year. J Am Geriatr Soc 67:329–335, 2019.

Association between Very Low Dietary Protein Intake and Subsequent Falls in Community-Dwelling Older Adults in the United States

“…Other tertile analyses found no protective association between protein intake and falls risk but did not evaluate subsequent falls risk and documented higher mean protein intake (92 gm/day) [16] vs. the means reported in our research (72.0/73.3 gm/day for those with/without subsequent falls). Previous studies have identified a protective association between protein intake and falls in older adults with unintentional weight loss [16,17]. Our research also identified weight loss of at least 10 lbs over a two-year period was associated with subsequent fall(s).…”

“…When protein intake has been evaluated as a continuous variable, some have reported their tertile analyses tended toward a protective association of subsequent falls (although most were not statistically significant) [17]. Other tertile analyses found no protective association between protein intake and falls risk but did not evaluate subsequent falls risk and documented higher mean protein intake (92 gm/day) [16] vs. the means reported in our research (72.0/73.3 gm/day for those with/without subsequent falls). Previous studies have identified a protective association between protein intake and falls in older adults with unintentional weight loss [16,17].…”

“…However, demonstrated links between specific malnutrition-related nutrients (including Vitamin D and protein which have important roles in muscle function, strength, and mass) and falls have not been firmly established [11][12][13][14]. Limited studies have specifically considered dietary protein intake and falls [15,16] or subsequent falls [17], even as many U.S. older adults consume less than the U.S. Recommended Dietary Allowance (RDA) for protein [18].…”

Dietary Protein Intake and Falls in Older People: Longitudinal Analyses From the Osteoarthritis Initiative

“…10 Finally, another more recent study found this lack of association in the sample as a whole and as a protective effect of dietary protein only in people reporting significant weight loss. 11 There are several factors that may explain these different findings. First, there were some methodological differences between the studies, including the sample size and follow-up period (which, in previous studies, was generally shorter than ours).…”

“…Fourth, at baseline, previous weight loss was not recorded, but in 2 studies this factor seems to be associated with a protective effect of protein intake on falls. 9,11 Finally, falls were only self-reported. In this sense, retrospective recall of falls each year over the past 12 months is an inferior way to ascertain falls rather than prospective monitoring (eg, monthly calendars), and the agreement between these 2 tools is often poor.…”