Caterina Trevisan1, Alessio Crippa2, Stina Ek3, Anna-Karin Welmer4, Giuseppe Sergi5, Stefania Maggi6, Enzo Manzato7, Jennifer W Bea8, Jane A Cauley9, Evelyne Decullier10, Vasant Hirani11, Michael J LaMonte12, Cora E Lewis13, Anne-Marie Schott14, Nicola Orsini2, Debora Rizzuto3. 1. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy. Electronic address: caterina.trevisan.5@phd.unipd.it. 2. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. 3. Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 4. Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden. 5. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy. 6. National Research Council, Neuroscience Institute, Padova, Italy. 7. Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy; National Research Council, Neuroscience Institute, Padova, Italy. 8. Department of Medicine, College of Medicine, Tucson, AZ; Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ. 9. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. 10. Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France. 11. Nutrition and Dietetics Group, School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia. 12. Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY. 13. Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL. 14. Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité de Recherche Clinique, Lyon, France; Université de Lyon, EA Health Services and Performance Research (HESPER), Lyon, France.
Abstract
OBJECTIVES: To evaluate the association between nutritional status, defined on the basis of a multidimensional evaluation, and body mass index (BMI) with the risk of falls and recurrent falls in community-dwelling older people. DESIGN: Systematic literature review and meta-analysis. SETTING AND PARTICIPANTS: Community-dwelling older adults. MEASURES: A systematic literature review was conducted on prospective studies identified through electronic and hand searches until October 2017. A random effects meta-analysis was used to evaluate the relative risk (RR) of experiencing falls and recurrent falls (≥2 falls within at least 6 months) on the basis of nutritional status, defined by multidimensional scores. A random effects dose-response meta-analysis was used to evaluate the association between BMI and the risk of falls and recurrent falls. RESULTS: People who were malnourished or those at risk for malnutrition had a pooled 45% higher risk of experiencing at least 1 fall than were those well-nourished (9510 subjects). Increased falls risk was observed in subjects malnourished versus well-nourished [RR 1.64, 95% confidence interval (CI) 1.18-2.28; 3 studies, 8379 subjects], whereas no substantial results were observed for risk of recurrent falls. A U-shaped association was detected between BMI and the risk for falls (P < .001), with the nadir between 24.5 and 30 (144,934 subjects). Taking a BMI of 23.5 as reference, the pooled RR of falling ranged between 1.09 (95% CI 1.04-1.15) for a BMI of 17, to 1.07 (95% CI 0.92-1.24) for a BMI of 37.5. No associations were observed between BMI and recurrent falls (120,185 subjects). CONCLUSIONS/IMPLICATIONS: The results of our work suggest therefore that nutritional status and BMI should be evaluated when assessing the risk for falls in older age.
OBJECTIVES: To evaluate the association between nutritional status, defined on the basis of a multidimensional evaluation, and body mass index (BMI) with the risk of falls and recurrent falls in community-dwelling older people. DESIGN: Systematic literature review and meta-analysis. SETTING AND PARTICIPANTS: Community-dwelling older adults. MEASURES: A systematic literature review was conducted on prospective studies identified through electronic and hand searches until October 2017. A random effects meta-analysis was used to evaluate the relative risk (RR) of experiencing falls and recurrent falls (≥2 falls within at least 6 months) on the basis of nutritional status, defined by multidimensional scores. A random effects dose-response meta-analysis was used to evaluate the association between BMI and the risk of falls and recurrent falls. RESULTS:People who were malnourished or those at risk for malnutrition had a pooled 45% higher risk of experiencing at least 1 fall than were those well-nourished (9510 subjects). Increased falls risk was observed in subjects malnourished versus well-nourished [RR 1.64, 95% confidence interval (CI) 1.18-2.28; 3 studies, 8379 subjects], whereas no substantial results were observed for risk of recurrent falls. A U-shaped association was detected between BMI and the risk for falls (P < .001), with the nadir between 24.5 and 30 (144,934 subjects). Taking a BMI of 23.5 as reference, the pooled RR of falling ranged between 1.09 (95% CI 1.04-1.15) for a BMI of 17, to 1.07 (95% CI 0.92-1.24) for a BMI of 37.5. No associations were observed between BMI and recurrent falls (120,185 subjects). CONCLUSIONS/IMPLICATIONS: The results of our work suggest therefore that nutritional status and BMI should be evaluated when assessing the risk for falls in older age.
Authors: Manuel Montero-Odasso; Nathalie van der Velde; Finbarr C Martin; Mirko Petrovic; Maw Pin Tan; Jesper Ryg; Sara Aguilar-Navarro; Neil B Alexander; Clemens Becker; Hubert Blain; Robbie Bourke; Ian D Cameron; Richard Camicioli; Lindy Clemson; Jacqueline Close; Kim Delbaere; Leilei Duan; Gustavo Duque; Suzanne M Dyer; Ellen Freiberger; David A Ganz; Fernando Gómez; Jeffrey M Hausdorff; David B Hogan; Susan M W Hunter; Jose R Jauregui; Nellie Kamkar; Rose-Anne Kenny; Sarah E Lamb; Nancy K Latham; Lewis A Lipsitz; Teresa Liu-Ambrose; Pip Logan; Stephen R Lord; Louise Mallet; David Marsh; Koen Milisen; Rogelio Moctezuma-Gallegos; Meg E Morris; Alice Nieuwboer; Monica R Perracini; Frederico Pieruccini-Faria; Alison Pighills; Catherine Said; Ervin Sejdic; Catherine Sherrington; Dawn A Skelton; Sabestina Dsouza; Mark Speechley; Susan Stark; Chris Todd; Bruce R Troen; Tischa van der Cammen; Joe Verghese; Ellen Vlaeyen; Jennifer A Watt; Tahir Masud Journal: Age Ageing Date: 2022-09-02 Impact factor: 12.782
Authors: Paul Obeng; Henneh Kwaku Kyereh; Jacob Owusu Sarfo; Edward Wilson Ansah; Priscilla Yeye Adumoah Attafuah Journal: BMC Geriatr Date: 2022-05-11 Impact factor: 4.070