Association between obesity, risk of falls and fear of falling in older women

Abstract The aim of this cross-sectional study was to investigate the association between obesity, risk of falls and fear of falling in older women. Two hundred and twenty-six volunteers (68.05 ± 6.22 years, 68.06 ± 11.79 kg, 1.56 ± 0.06 m) were classified as normal weight, overweight or obese, according to the body mass index. Risk of falls and fear of falling were evaluated using QuickScreen Clinical Falls Risk Assessment and Falls Efficiency Scale – International (FES-I), respectively. Comparisons between groups were conducted using Chi-square and ANOVA One-way tests. The significance level was set at p< 0.05. Obesity was associated with greater probability of falls (p< 0.001), which may be partly explained by decreased muscle strength (p< 0.001) and reaction time (p< 0.001). In addition, significant differences between groups was observed in FES-I score (p< 0.01), with obese women showing more pronounced fear of falling (30.10 ± 8.4) than normal weigh (25. 33 ± 7.11, p< 0.01) and overweight subjects (26.97 ± 7.05, p< 0.05). These findings corroborate previous evidence pointing obesity as a major risk factor for falls. Therefore, health professionals dealing with fall prevention should consider the effects of overweight.

摘要
本横断面研究（cross-sectional study）旨在探讨老年女性的肥胖状况、跌倒风险与跌倒恐惧三者间的关联。研究共纳入226名志愿者，年龄为68.05±6.22岁，体重68.06±11.79kg，身高1.56±0.06m；依据体质量指数（Body Mass Index, BMI）将受试者划分为体重正常、超重及肥胖三组。分别采用快速筛查临床跌倒风险评估工具（QuickScreen Clinical Falls Risk Assessment）与跌倒效能感量表-国际版（Falls Efficiency Scale – International, FES-I），对跌倒风险及跌倒恐惧进行评估。组间比较采用卡方检验（Chi-square test）与单因素方差分析（One-way ANOVA），显著性水准设定为p<0.05。

结果表明，肥胖与更高的跌倒发生概率显著相关（p<0.001），该关联可部分通过肌肉力量降低（p<0.001）与反应时间缩短（p<0.001）得到解释。此外，三组受试者的FES-I得分存在显著组间差异（p<0.01），其中肥胖组女性的跌倒恐惧程度更为显著，其得分（30.10±8.4）高于体重正常组（25.33±7.11，p<0.01）与超重组（26.97±7.05，p<0.05）。本研究结果佐证了既往研究结论，即肥胖是跌倒发生的主要危险因素，因此从事跌倒预防工作的医疗专业人员应重视超重带来的影响。