Dynapenic Abdominal Obesity And The Incidence Of Falls In Older Women: An 18-month Follow-up Study

Abstract

PURPOSE: To assess the association between dynapenic abdominal obesity (DAO) and the incidence of falls over 18 months in older community-dwelling women. METHODS: A total of 188 older women (67.97±6.02 years; 27.70kg/m2) underwent waist circumference (WC) measurement and had handgrip strength assessed at the dominant arm using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength as cut-off value (20.7kgf), while obesity was considered as a WC > 88cm. DAO was the combination of both aforementioned criteria. Therefore, volunteers were divided into 4 groups: Eutrophic, Dynapenic, Obese, and DAO. Participants were tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and modified Poison regressions were conducted. RESULTS: Proportions of each classification were 17.6%, 46.8%, 13.3%, and 22.3% for eutrophic, obese, dynapenic, and DAO, respectively. The incidence of falls over 18-month follow-up period was 24.5%. Thus, the proportion of fallers regarding each classification were 12.1%, 12%, 25%, and 40.5% for eutrophic, dynapenic, obese, and DAO, respectively (X2=10.662; p=0.014). Noteworthy, only DAO was consistently associated with a higher risk of falls (relative risk: 3.339; 95% CI: 1.242-8.979), even after adjustments for age, body mass index, physical activity level, regular use of four or more medications, reduced peripheral sensation, presence of two or more chronic diseases, and history of lower-limbs pain. CONCLUSIONS: These results provide support for the concept that the combination of abdominal obesity and dynapenia has clinical implications and might be an useful supplement to other routine falls risk assessment tools. These relationships were stronger than obesity or dynapenia alone.