Body Mass Index, Falls, and Hip Fractures Among Nursing Home Residents

To examine the association between body mass index (BMI) and the risk for falls and hip fractures among nursing home (NH) residents.

A cohort study of newly admitted NH residents, excluding those with a prior history of hip fracture. Using the Minimum Data Set 2.0 (2006-2010), we determined the occurrence of new falls and hip fractures among NH residents during their first 3 months of stay. Residents were categorized as underweight (BMI < 18.5), normal-to-overweight (18.5 ≤ BMI < 30), mildly obese (30 ≤ BMI < 35), and moderately-to-severely obese (BMI ≥ 35).

Among newly admitted NH residents over the first 3 months, 51.1% of underweight residents, 53.1% of normal-to-overweight residents, 49.1% of residents with mild obesity, and 43.1% of residents with moderate-to-severe obesity experienced a fall; 3.1% of underweight residents, 2.5% of normal-to-overweight residents, 1.5% of residents with mild obesity, and 1.1% of residents with moderate-to-severe obesity experienced a hip fracture. In comparison with normal-to-overweight residents, after adjustment for resident-level and facility-level characteristics, mildly obese residents (odds ratio [OR] = 0.94, 95% confidence interval [CI] = [0.91-0.93]), and moderately-to-severely obese residents (OR = 0.84 [95% CI = 0.83-0.85]) were less likely to experience a fall; Mildly obese residents (OR = 0.65 [95% CI = 0.63-0.68]), and moderately-to-severely obese residents (OR = 0.84 [95% CI = 0.83-0.85]) were less likely, and underweight residents were more likely (OR = 1.22 [95% CI = 1.18-1.26]) to experience a hip fracture.

Obesity is associated with reduced risks for falls and hip fractures among newly admitted NH residents. Future studies are needed to explore possible explanations for these associations.