Osteoporosis International

, Volume 21, Issue 2, pp 351–357 | Cite as

Osteoporosis and gait and balance disturbances in older sarcopenic obese New Zealanders

  • D. L. Waters
  • L. Hale
  • A. M. Grant
  • P. Herbison
  • A. Goulding
Original Article



Bone, muscle, and fat may affect gait and balance in older adults. Osteoporosis was prevalent in low muscle mass participants and related to gait and balance deficits. Low muscle combined with high fat mass had more functional deficits and poorer bone health, which has implications for falls risk and fractures.


Decreasing bone density and muscle mass and increasing fat mass may act synergistically to affect gait and balance in older adults.


One hundred eighty-three older adults (age 72.7 ± 6 years, range 56–93; body mass index 28.2 ± 4.9, range 16.6–46.0) were recruited from a New Zealand falls prevention intervention trial. Total and appendicular skeletal muscle mass (ASM), percent fat, and bone mineralization were assessed by dual energy X-ray absorptiometry and used to characterize normal lean (NL, n = 51), sarcopenic (SS, n = 18), sarcopenic obese (SO, n = 29), and obese (OO, n = 85) phenotypes. Functional performance was assessed using timed up and go, chair stand, single leg stand, and step test. Regression models were adjusted for age, sex, medications, and physical activity.


Femoral neck osteoporosis was present in 22% SS, 17% SO, 12% NL, and 7% OO. Femoral neck osteoporosis with low ASM predicted poor chair stand performance (β −3.3, standard error 1.6, p = 0.04). SO scored lowest on the chair stand (p = 0.03) and step test (p = 0.03). Higher ASM predicted faster timed up and go performance (p = 0.001).


Osteoporosis was prevalent in low ASM groups (SS and SO) and related to gait and balance deficits, particularly in the SO. This has implications for falls risk, fractures, and interventions.


Aging Bone mineral density Physical performance Sarcopenia Sarcopenic obesity 



This study was supported and partially funded by the Accident Compensation Corporation New Zealand and a University of Otago Research grant. We wish to extend a sincere thank you to the volunteers for their participation in this study. We also wish to thank Glenys Forsyth, Carolyn Jenkins, John Stanway, and David Jackson for their assistance in data collection, management, and editing.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • D. L. Waters
    • 1
  • L. Hale
    • 2
  • A. M. Grant
    • 3
  • P. Herbison
    • 1
  • A. Goulding
    • 3
  1. 1.Department of Preventive and Social MedicineDunedin School of Medicine, University of OtagoDunedinNew Zealand
  2. 2.Centre for Physiotherapy ResearchSchool of Physiotheraphy, University of OtagoDunedinNew Zealand
  3. 3.Department of Medical and Surgical SciencesDunedin School of Medicine, University of OtagoDunedinNew Zealand

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