Association Between Dynapaenic Abdominal Obesity and Fall Risk in Middle-Aged and Older Chinese Adults

The study aimed to examine the relationship between dynapaenic abdominal obesity (D/AO) and fall risk in Chinese middle-aged and older adults.

We analysed data from 9364 participants in the China Health and Retirement Longitudinal Study (CHARLS 2011-2018). Participants were categorised into four groups: non-dynapaenia and non-abdominal obesity (ND/NAO), only abdominal obesity (ND/AO), only dynapaenia (D/NAO), and D/AO. Cox regression, sensitivity, subgroup and geographic analyses were conducted.

During follow-up, 2989 falls were reported. After full adjustment, D/NAO and D/AO significantly increased fall risk by 44% (HR = 1.44, 95% CI: 1.25-1.65) and 28% (HR = 1.28, 95% CI: 1.05-1.57), respectively. Stratified analysis revealed significant sex differences: among males, the association between D/AO and fall risk was most pronounced (HR = 2.26, 95% CI: 1.58-3.23); among females, the risk was primarily driven by D/NAO (HR = 1.32, 95% CI: 1.07-1.62). Diabetes significantly interacted with D/AO status (p < 0.05), intensifying the risk. Geographically, Northeast China exhibited high D/AO-associated fall risk despite having the optimal baseline muscle strength.

Both D/NAO and D/AO are important risk factors for falls in middle-aged and older adults. The effect of abdominal obesity on fall risk differs significantly by sex and diabetes status, demonstrating a notable synergistic pathogenic effect. Fall prevention strategies should focus on comprehensive body composition management. In particular, for men and individuals with diabetes, greater emphasis should be placed on muscle strength training and the control of central obesity. For high-risk regions (e.g., Northeast China), in addition to physiological interventions, multidimensional public health prevention strategies should be developed that take into account local environments.