Association between weight and body composition changes with falls risk in the Malaysian Elders Longitudinal Research (MELoR) study

Abstract

Objective Both changes in body composition and increased fall risk occur with increasing age. While weight management may be considered a component of falls prevention, the long-term consequences of changes in weight, however, remain uncertain. This prospective study aimed to evaluate the relationship between weight and body composition changes over 5 years with fall occurrence.Design Prospective cohort study.Setting Community-dwelling older adults interviewed at baseline (2013–2016) and follow-up (2020–2022) as a part of the Malaysian Elders Longitudinal Research study were included.Participants Participants who attended face-to-face follow-up visits.Primary and secondary outcome measures Fall occurrence over 12 months preceding the follow-up visit was determined. Anthropometric, bioimpedance analysis and physical performance measurements were obtained at both time points. Participants were categorised into three groups according to changes in weight and body composition using≥5% increase or decrease in weight to determine loss or gain.Results Of the 225 participants, aged 71.8±6.8 years, 128 (56.9%) were women. Weight gain was associated with increased fall risk at follow-up compared with stable weight (adjusted rate ratio, aRR (95% confidence interval, CI)=2.86 (1.02–8.02)) following adjustments for age and body mass index (BMI), but this relationship was attenuated by low baseline percentage lean body mass (%LBM) in women. The association was strenghtened after adjusting for age, BMI, and low muscle strength (aRR (95% CI)=2.89 (1.01–8.28)). Weight change did not influence falls risk in men. No difference was observed with changes in percentage body fat and %LBM over time with fall occurrence for both genders.Conclusion Lower baseline lean body mass influenced the relationship between weight gain and falls longitudinally. Interventions addressing low lean body mass should be considered in the prevention of weight-gain-related falls in older women.