Debra Waters, Department of Medicine / School of Physiotherapy, University of Otago PO Box 56, Dunedin 9054, New Zealand,
J Nutr Health Aging. 2019;23(1):9-13. doi: 10.1007/s12603-018-1087-4.
Sarcopenia and obesity are reported risk factors for falls, although the data are not consistent and most studies do not make sex comparisons. We investigated whether falls were associated with balance, gait, and body composition, and whether these relationships are sex-specific.
Secondary analysis of 4-year follow-up data from of the New Mexico Aging Process Study.
Albuquerque, New Mexico.
307 participants (M, n=122, 75.8 yr. SD5.5; F, n=183, 74.6yr SD6.1).
Gait and balance were assessed annually using the Tinetti test. Lean body mass (LBM), appendicular skeletal muscle mass (ASM), fat free mass (FFM), total fat mass (FM) were assessed annually by DXA. Falls were assessed using bimonthly falls calendars. Hazard ratios (HR) for 2-point worsening in gait and balance score and falls were calculated by Cox proportional hazard for men and women.
Baseline balance deficits, and not body composition, represented the strongest predictor of falls. For the total balance score, the variables with significant sex interactions were ASM (Male-HR 1.02 95%CI 0.60-1.73; Female-HR 1.92 95%CI 1.05-3.52, p=0.03) and FFM (Male-HR 1.04 95%CI 0.64-1.70; Female-HR 1.91 95%CI 1.12-3.24, p=0.04), after adjustment for age, sarcopenia and physical activity. The body composition relationship with balance deficits was U-shaped with the strongest predictors being low LBM in males and high FM in females.
Specific body composition components and balance deficits are risk factors for falls following sex-specific patterns. Sex differences need to be explored and considered in interventions for worsening balance and falls prevention.
肌少症和肥胖被报道为跌倒的风险因素，尽管数据不一致，且大多数研究未进行性别比较。我们调查了平衡、步态和身体成分是否与跌倒有关，以及这些关系是否具有性别特异性。
新墨西哥衰老研究的 4 年随访数据的二次分析。
新墨西哥州阿尔伯克基。
307 名参与者（男性，n=122，75.8 岁 ±5.5 岁；女性，n=183，74.6 岁 ±6.1 岁）。
每年使用 Tinetti 测试评估步态和平衡。每年通过 DXA 评估瘦体重（LBM）、四肢骨骼肌质量（ASM）、去脂体重（FFM）和总脂肪量（FM）。使用双月跌倒日历评估跌倒。使用 Cox 比例风险模型计算男性和女性步态和平衡评分恶化 2 分和跌倒的风险比（HR）。
基线平衡缺陷，而不是身体成分，是跌倒的最强预测因素。对于总平衡评分，具有显著性别交互作用的变量是 ASM（男性 HR 1.02 95%CI 0.60-1.73；女性 HR 1.92 95%CI 1.05-3.52，p=0.03）和 FFM（男性 HR 1.04 95%CI 0.64-1.70；女性 HR 1.91 95%CI 1.12-3.24，p=0.04），调整年龄、肌少症和体力活动后。身体成分与平衡缺陷的关系呈 U 型，最强的预测因素是男性低 LBM 和女性高 FM。
特定的身体成分成分和平衡缺陷是跌倒的风险因素，具有性别特异性模式。需要探索和考虑性别差异，以改善平衡和预防跌倒。
