Sarcopenic obesity and dynapenic obesity: 5-year associations with falls risk in middle-aged and older adults

To determine whether obesity concurrent with sarcopenia (low muscle mass) or dynapenia (low muscle strength) is associated with increased falls risk in middle-aged and older adults.

5-year prospective cohort study including 674 community-dwelling volunteers (mean ± SD age 61.4 ± 7.0 years; 48% female). Sarcopenia and dynapenia were defined as lowest sex-specific tertiles for dual-energy X-ray (DXA)-assessed appendicular lean mass (adjusted for height and fat mass) or lower-limb strength, respectively. Obesity was defined as the highest tertiles of DXA-assessed total or trunk fat mass. Change in falls risk was calculated using the Physiological Profile Assessment (z-scores: 0-1 = mild increased risk; 1-2 = moderate increased risk; >2 = marked increased risk).

Multivariable linear regression analyses revealed mild but significantly increased falls risk scores for dynapenic obesity (change in mean z-score compared to non-dynapenic, non-obese group: 0.33, 95% CI 0.06-0.59 [men] and 0.46, 95% CI 0.21-0.72 [women]) and dynapenia (0.25, 95% CI 0.05-0.46 [women only]).

Dynapenic obesity, but not sarcopenic obesity, is predictive of increased falls risk score in middle-aged and older adults. In clinical settings, muscle function assessments may be useful for predicting falls risk in obese patients.