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Exploring the Association Between Measures of Obesity and Measures of Trip-induced Fall Risk Among Older Adults

  • Noah J. Rosenblatt
    Correspondence
    Corresponding author Noah J. Rosenblatt, PhD, Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd, North Chicago, IL 60064.
    Affiliations
    Dr William M. Scholl College of Podiatric Medicine's Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science, North Chicago, IL
    Search for articles by this author
  • Michael L. Madigan
    Affiliations
    Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA
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Published:August 02, 2021DOI:https://doi.org/10.1016/j.apmr.2021.06.013

      Abstract

      Objective

      To explore the association between measures of obesity and measures of trip-induced fall risk among community-dwelling older adults.

      Design

      Case-control.

      Setting

      Gait laboratory.

      Participants

      Voluntary sample of 55 community-dwelling older adults (aged ≥65y; N=55) with body mass index (BMI) of 18.84-44.68 kg/m2.

      Interventions

      Not applicable.

      Main Outcome Measures

      Measures of obesity included 6 anthropometry-based measures (BMI; thigh, hip and waist circumferences; ratio of waist-to-hip circumference; index of central obesity) and 4 dual-energy x-ray absorptiometry–based measures (percentage trunk, leg, and total fat; fat mass index). Measures of risk of tripping during overground walking included median and interquartile range of toe clearance and area under the swing phase toe trajectory. Measures of trip recovery after a laboratory-induced trip included trunk angle and angular velocity at ground contact of the first recovery step, anteroposterior distance from stepping foot to center of mass at the same instant, and step time of the first recovery step.

      Results

      Risk of tripping was associated with waist-to-hip ratio and thigh circumference. After grouping participants by waist-to-hip ratio, those with high ratios (≥0.9 cm for men and ≥0.85 cm for women) exhibited significantly greater variability in toe clearance. Trip recovery was associated with hip circumference, thigh circumference, fat mass index, and total fat. After grouping participants by fat mass index, those with high indices (>9 kg/m2 for men and >13 kg/m2 for women) exhibited less favorable trunk kinematics after a laboratory-induced trip (Cohen d=0.84).

      Conclusions

      Waist-to-hip ratio and fat mass index may more closely relate to trip-induced fall risk than BMI among community-dwelling older adults.

      Keywords

      List of abbreviations:

      BMI (body mass index), COM (center of mass), DEXA (dual-energy x-ray absorptiometry), IQR (interquartile range), PC (principal component), PCA (principal component analysis)
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