The influence of obesity on falls and quality of life

Cecilie Fjeldstad, Anette S Fjeldstad, Luke S Acree, Kevin J Nickel, Andrew W Gardner, Cecilie Fjeldstad, Anette S Fjeldstad, Luke S Acree, Kevin J Nickel, Andrew W Gardner

Abstract

Objective: To determine (1) whether obese older adults had higher prevalence of falls and ambulatory stumbling, impaired balance and lower health-related quality of life (HRQL) than their normal weight counterparts, and (2) whether the falls and balance measures were associated with HRQL in obese adults.

Methods: Subjects who had a body mass index (BMI) greater than 30 kg/m2 were classified into an obese group (n = 128) while those with BMI between 18.5 and 24.9 kg/m2 were included into a normal weight group (n = 88). Functional tests were performed to assess balance, and questionnaires were administered to assess history of falls, ambulatory stumbling, and HRQL.

Results: The obese group reported a higher prevalence of falls (27% vs. 15%), and ambulatory stumbling (32% vs. 14%) than the normal weight group. Furthermore, the obese group had lower HRQL, (p < or = 0.05) for physical function (63 +/- 27 vs. 75 +/- 26; mean +/- SD), role-physical (59 +/- 40 vs. 74 +/- 37), vitality (58 +/- 23 vs. 66 +/- 20), bodily pain (62 +/- 25 vs. 74 +/- 21) and general health (64 +/- 19 vs. 70 +/- 18). In the obese group, a history of falls was related (p < or = 0.05) to lower scores in 4 domains of HRQL, and ambulatory stumbling was related (p < or = 0.01) to 7 domains.

Conclusion: In middle-aged and older adults, obesity was associated with a higher prevalence of falls and stumbling during ambulation, as well as lower values in multiple domains of HRQL. Furthermore, a history of falls and ambulatory stumbling were related to lower measures of HRQL in obese adults.

References

    1. Kannus P, Parkkari J, Koskinen S, Niemi S, Palvanen M, Järvinen M, Vuori I. Fall-induced injuries and deaths among older adults. JAMA. 1999;281:1895–1899. doi: 10.1001/jama.281.20.1895.
    1. Stevens JA, Hasbrouck LM, Durant TM, Dellinger AM, Batabyal PK, Crosby AE, Valluru BR, Kresnow M, Guerrero JL. Surveillance for injuries and violence among older adults. MMWR CDC Surveill Summ. 1999;48:27–50.
    1. Freidmann JM, Elasy T, Jensen GL. The relationship Between Body Mass Index and Self-Reported Functional Limitation Among Older Adults: A Gender Difference. J Am Geriatr Soc. 2001;49:398–403. doi: 10.1046/j.1532-5415.2001.49082.x.
    1. Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health. 1994;84:565–570.
    1. Lawrence RH, Tennstedt SL, Kasten LE, Shih J, Howland J, Jette AM. Intensity and correlates of fear of falling and hurting oneself in the next year. J Aging Health. 1998;10:267–286. doi: 10.1177/089826439801000301.
    1. Howland J, Lachman ME, Peterson EW, Cote J, Kasten L, Jette A. Covariates of fear of falling and associated activity curtailment. Gerontologist. 1998;38:549–555.
    1. Burker EJ, Wong H, Sloane PD, Mattingly D, Preisser J, Mitchell CM. Predictors of fear of falling in dizzy and nondizzy elderly. Psychol Aging. 1995;10:104–110. doi: 10.1037/0882-7974.10.1.104.
    1. Finkelstein MM. Body mass index and quality of life in a survey of primary care patients. J Fam Pract. 2000;49:734–737.
    1. Goins TR, Spencer MS, Krummel DA. Effect of obesity on health-related quality of life among Appalachian elderly. South Med J. 2003;96:552–557. doi: 10.1097/.
    1. Hill-Briggs F, Gary TL, Hill MN, Bone LR, Brancati FL. Health-related quality of life in urban African Americans with type 2 diabetes. J Gen Intern Med. 2002;17:412–419. doi: 10.1046/j.1525-1497.2002.11002.x.
    1. Richardson JK, Hurvitz EA. Peripheral neuropathy: a true risk factor for falls. J Gerontol A Biol Sci Med Sci. 1995;50:M211–M215.
    1. Rosmond R, Bjorntorp P. Quality of life, overweight, and body fat distribution in middle-aged men. Behav Med. 2000;26:90–94.
    1. Katz DA, Mchorney CA, Atkinson RL. Impact of Obesity on Health-related Quality of Life in Patients with Chronic Illness. JGIM. 2000;15:789–796. doi: 10.1046/j.1525-1497.2000.90906.x.
    1. de Rekeneire N, Visser M, Peila R, Nevitt MC, Cauley JA, Tylacsky FA, Simonsick EM, Harris TB. Is a Fall just a Fall: Correlates of Falling in Healthy Older Persons. The Health, Aging and Body Composition Study. JAGS. 2003;51:841–846. doi: 10.1046/j.1365-2389.2003.51267.x.
    1. Maffiuletti NA, Agosti F, Proietti M, Riva D, Resnik M, Lafortuna CL, Sartorio A. Postural instability of extremely obese individuals improves after a body weight reduction program entailing specific balance training. J Endocrinol Invest. 2005;28:2–7.
    1. Teasdale N, Hue O, Marcotte J, Berrigan F, Simonau M, Doré J, Marceau P, Marceau S, Tremblay A. Reducing weight increases postural stability in obese and morbid obese men. Int J Obes (Lond) 2007;31:153–160. doi: 10.1038/sj.ijo.0803360.
    1. Gardner AW, Montgomery PS. Impaired balance and higher prevalence of falls in subjects with intermittent claudication. J Gerontol A Biol Sci Med Sci. 2001;56:M454–M458.
    1. Gardner AW, Montgomery PS. The relationship between history of falling and physical function in subjects with peripheral arterial disease. Vasc Med. 2001;6:223–227. doi: 10.1177/1358836X0100600404.
    1. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–1707.
    1. Brown M, Sinacore DR, Binder EF, Kohrt WM. Physical and performance measures for the identification of mild to moderate frailty. J Gerontol A Biol Sci Med Sci. 2000;55:M350–M355.
    1. Acree LS, Longfors J, Fjeldstad AS, Fjeldstad C, Schank B, Nickel KJ, Montgomery PS, Gardner AW. Physical activity is related to quality of life in older adults. Health Qual Life Outcomes. 2006;4:1–6. doi: 10.1186/1477-7525-4-37.
    1. Lyons RA, Perry HM, Littlepage BN. Evidence for the validity of the Short-form 36 Questionnaire (SF-36) in an elderly population. Age Ageing. 1994;23:182–184. doi: 10.1093/ageing/23.3.182.
    1. Rejeski WJ, Mihalko SL. Physical activity and quality of life in old adults. J Gerontol A Biol Sci Med Sci. 2001;56:23–35.
    1. Ware JE, Kosinki M, Bayliss MS, Mchorney CA, Rogers WH, Raczek A. Comparison of methods for scoring and analysis of the SF-36 health profiles and summary measures. Med Care. 1995;33:AS264–279. doi: 10.1097/00005650-199501001-00005.
    1. Ware JJ, Sherbourne CD. The MOS 36-item short-form survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483. doi: 10.1097/00005650-199206000-00002.
    1. Steadman J, Donaldson N, Kalra L. A Randomized Controlled Trial of an Enhanced balance Training Program to Improve Mobility and reduce Falls in Elderly Patients. J Am Geriatr Soc. 2003;51:847–852. doi: 10.1046/j.1365-2389.2003.51268.x.
    1. Corbeil P, Simoneau M, Rancourt D. Increased risk for falling associated with obesity: mathematical modeling of postural control. IEEE trans neural Syst Rehabil Eng. 2001;9:126–36. doi: 10.1109/7333.928572.
    1. Bruce DG, Devine A, Prince RL. Recreational Physical Activity in Healthy Older Women: The Importance of Fear of Falling. J Am Geriatr Soc. 2002;50:84–9. doi: 10.1046/j.1532-5415.2002.50012.x.
    1. Brouwer BJ, Walker C, Rydahl SJ, Culham EG. Reducing fear of Falling in Seniors Through Education and Activity Programs: A Randomized Trial. JAGS. 2003;51:829–834. doi: 10.1046/j.1365-2389.2003.51265.x.
    1. Fuzhong LI, Harmer P, Fisher JK, Mcauley E. Tai Chi: Improving Functional Balance and Predicting Subsequent Falls in Older Persons. Med Sci Sports Exerc. 2004;36:2046–2052.
    1. Hatch J, Gill-Body KM, Portney LG. Determinants of Balance Confidence in Community-Dwelling Elderly People. Phys Ther. 2003;83:1072–1079.
    1. Han TS, Tijhuis MAR, Lean MEJ. Quality of Life in Relation to Overweight and Fat Distribution. Am J Public Health. 1998;88:1814–20.
    1. Jensen GL, Rogers J. Obesity in Older persons. J Am Diet Assoc. 1998;98:1308–1311. doi: 10.1016/S0002-8223(98)00293-4.

Source: PubMed

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