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Association between body mass index and falls in community-dwelling men and women: a prospective, multinational study in the Survey of Health, Ageing and Retirement in Europe (SHARE)

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Key summary points

AbstractSection Aim

To explore the longitudinal association between body mass index categories and falls risks in community-dwelling men and women aged ≥ 50 years in the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE).

AbstractSection Findings

Underweight and obese participants had a higher falls risk, compared to those with normal weight. These associations were independent of age, self-rated health, previous falls, comorbidities and medications.

AbstractSection Message

The relationship between body mass index and falls risk in adults is U-shaped; both underweight and obesity are associated with increased falls risk, compared to normal weight.

Abstract

Purpose

To investigate the longitudinal associations between body mass index (BMI) categories and falls risk in men and women.

Methods

Prospective cohort study using data from 50,041 community-dwelling adults aged ≥ 50 years assessed in Wave 6 and 7 in the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE). Socio-demographic and clinical factors were assessed at baseline (Wave 6). Functional impairment was defined by any limitations in activities of daily living (ADL) or instrumental ADL (IADL). Participants were classified as underweight, normal weight, overweight or obese at baseline. At 2-year follow-up (Wave 7), falls in the previous six months were recorded. The longitudinal associations between BMI categories and falls were analysed by binary logistic regression models; odds ratios (OR) and 95% confidence intervals (CI) were calculated. All analyses were adjusted for socio-demographic and clinical factors. Furthermore, analyses were stratified by sex, age and functional impairment.

Results

Mean age was 67.0 years (range 50–102); 28,132 participants were women; 4057 (8.1%) participants reported falls at follow-up. Participants had an increased falls risk [OR (95% CI)] if they were underweight [1.41 (1.06–1.88), p = 0.017] or obese [1.20 (1.09–1.32), p < 0.001] compared to those with normal weight. The association of underweight and obesity with increased falls risk was consistent in participants aged ≥ 65 years. In participants with functional impairment, underweight was associated with higher falls risk [1.61 (1.09–2.40), p = 0.018], while obesity was not.

Conclusion

A U-shaped relationship between BMI and falls risk was found in community-dwelling adults.

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Availability of data and material

Data are available upon request from the SHARE website (see http://www.share-project.org/data-access/user-registration.html).

Code availability

Not applicable.

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Acknowledgements

Dr. Giulia Ogliari was supported by Grant APP2380/N7359 (N7359 Osteoporosis and Falls Research for ‘Improving Quality of Life In Older Patients’) by Nottingham Hospitals Charity, Nottingham, UK. This paper uses data from SHARE Wave 6 and 7, release 7.1.0, as of 16 June 2020. The SHARE data collection has been primarily funded by the European Commission through the fifth framework programme (project QLK6-CT-2001–00 360 in the thematic programme Quality of Life), through the sixth framework programme (projects SHARE-I3, RII-CT- 2006–0 62 193; COMPARE, CIT5-CT-2005–0 28 857; and SHARELIFE, CIT4-CT-2006–0 28 812) and through the seventh framework programme (SHARE-PREP, 2 11 909 and SHARE- LEAP, 227822). Additional funding from the US National Institute on Ageing (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, Y1-AG-4553–01 and OGHA 04–064, IAG BSR06-11, R21 AG025169) as well as from various national sources is gratefully acknowledged (see http://www.share-project.org/contact-organisation/funding.html for a full list of funding institutions).

Funding

Dr. Giulia Ogliari was supported by Grant APP2380/N7359 (OSTEOPOROSIS and FALLS RESEARCH) by Nottingham Hospitals Charity.

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Authors and Affiliations

  1. Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, Nottinghamshire, NG7 2UH, UK

    Giulia Ogliari & Tahir Masud

  2. Department of Geriatric Medicine, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark

    Jesper Ryg, Karen Andersen-Ranberg & Tahir Masud

  3. Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense, Denmark

    Jesper Ryg & Karen Andersen-Ranberg

  4. Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J.B. Winslowvej 9B, 5000, Odense, Denmark

    Karen Andersen-Ranberg & Lasse Lybecker Scheel-Hincke

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GO: study concept, data analysis, drafting the manuscript. JR, KAR, LLSH and TM: study concept, critical revision of manuscript for intellectual content. All authors read and approved the final manuscript.

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Ogliari, G., Ryg, J., Andersen-Ranberg, K. et al. Association between body mass index and falls in community-dwelling men and women: a prospective, multinational study in the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur Geriatr Med 12, 837–849 (2021). https://doi.org/10.1007/s41999-021-00485-5

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