Body fat distribution in obesity and the association with falls: A cohort study of Brazilian women aged 60 years and over.

Objectives: Obesity is associated with an increased risk of falls in older women; however, it is not certain how body fat distribution affects this relationship. This study examined the association between android and gynoid obesity and the incidence of falls in women aged 60 years and over.

Study Design: Participants were recruited from the community in Brasilia, Brazil. At baseline, participants underwent obesity screening using dual-energy x-ray absorptiometry. Participants identified as obese (body fat percentage >42 %) were classified as android or gynoid type, based on the median of the android-gynoid fat percent ratio (0.99). Incident falls were recorded at the end of the 18-month follow-up period via participant recall. Chi-square test and modified Poisson regression were used to examine the association between obesity and falls.

Results: A total of 246 participants were recruited and 204 completed the follow-up. The gynoid obese group had a larger proportion of fallers (n = 27, 41 %) than the android obese (n = 17, 24 %) and non-obese (n = 12, 18 %) groups (p = .009). Compared with non-obese women, participants with gynoid obesity were more likely to experience a fall (RR: 2.09, 95 %CI: 1.13-3.87). The risk of falling did not differ between non-obese participants and those with android obesity (RR: 1.26, 95 %CI: 0.64-2.50).

Conclusions: Gynoid obesity is associated with an increased risk of falls in women aged 60 years and over. Screening for body fat distribution as a supplement to other risk factors for falls may help to identify older adults at a greater risk of falling and to prompt early implementation of fall prevention programs.