Intercontinental difference in the association between obesity and falls among older persons

Obesity in older persons may increase the risk of falls, but this relationship may vary depending on body composition and cultural behaviors, which may vary across regions and ethnic groups. This study aims to explore the differences in the association between increased BMI and falls among Asian and Caucasian populations, using data from the Malaysian Elders Longitudinal Research (MELoR), the Bavarian Research Association-Sarcopenia and Osteoporosis (FORMOsA) and the 3rd Health Check for European Prospective Investigation of Cancer-Norfolk (EPIC-NORFOLK) studies.

We analyzed baseline data from the MELoR, FORMOsA, and EPIC-NORFOLK cohorts, focusing on older women aged ≥65 years (MELoR), ≥70 years (FORMOsA), and ≥55 years (EPIC-NORFOLK). We assessed body mass index (BMI), body composition, fall risk, and physical performance (gait speed, handgrip strength) to explore the relationship between BMI and falls, conducting cross-country and ethnic subgroup analyses. Statistical analysis was performed using multivariable logistic regression to controlling for confounding factors.

A total of 10,265 participants aged 55 and over were eligible to be included. The prevalence of people with falls was higher in FORMOsA (54.4%) compared to both MELoR (22.5%) and EPIC-NORFOLK (26.9%) cohorts. It found significant differences in age, gender, BMI, body fat, and fall prevalence across the three cohorts. BMI was significantly associated with fall risk in both the MELoR and FORMOsA studies, but not the EPIC-NORFOLK study. The relationship between BMI and falls remained unchanged after adjustment for age, gender, marital status, education level, smoking status, number of medications and medical comorbidities.

Intercontinental and international variations were observed in the relationship between BMI and falls among adults aged 55 and older. While higher BMI was linked to increased fall risk in some populations, these associations varied by body composition and country, suggesting the need for culturally tailored fall prevention strategies among older persons.