Sarcopenia and physical performance among older adults with increased body mass index and falls

Adiposity-related mechanisms likely impair performance and dynamic balance, leading to fall. This study aims to assess the role of sarcopenia and physical performance tests in predicting falls among individuals with increased body mass index (BMI) (≥ 25 kg/m²) compared to those with normal BMI (< 25 kg/m²). This cross-sectional study recruited 604 community-dwelling adults (≥ 60 years). Body composition, fall history, sarcopenia, timed-up and go (TUG), handgrip strength (HGS), and gait speed (GS) were assessed. Participants were grouped by BMI and fall history. Logistic regression model was adjusted for potential confounders. Individuals with increased BMI had higher odds of sarcopenia than non-fallers with normal BMI. Among BMI < 25 kg/m² fallers, low GS was higher (OR (95% CI) 1.64 (1.04-2.58)), but was attenuated by comorbidities. Low TUG was significant in both BMI groups, but only remained significant for normal BMI fallers (OR (95% CI) 3.74 (1.31-10.72)), potentially due to anthropometric measures. Reduced HGS was significant within BMI ≥ 25 kg/m², but was influenced by fat percentage. HGS demonstrated better discriminatory ability for falls in older adults with increased BMI. The higher odds of sarcopenia among fallers with high BMI highlight the need for intervention studies addressing sarcopenic obesity as a growing risk factor for falls.