The Relationship Between Obesity and Falling in Older Adults

描述(由申请者提供)：肥胖是一种复杂的情况，可以影响到功能的几个方面。此前的研究发现，在老年人中，肥胖与几种慢性病的高患病率、较低的生活质量和行动不便有关。然而，身体机能的一个组成部分与肥胖的关系还没有得到很好的研究，那就是跌倒的风险。跌倒和与跌倒有关的伤害在老年人中是一个非常重要的健康问题。跌倒会导致严重的发病率、功能独立性丧失和死亡。在社会层面上，与跌倒有关的伤害大大增加了医疗保健费用，导致每年数十亿美元的支出。虽然肥胖和跌倒在老年人中都是非常普遍的疾病，但对这两种疾病如何相互作用的了解非常有限。有趣的是，肥胖可能通过多种潜在机制影响跌倒的风险。先前的工作已经确定了几个与患者相关的老年人跌倒的危险因素，包括活动能力和平衡障碍、疼痛、抑郁、慢性疾病和缺乏体育活动。以前的研究还表明，肥胖与活动能力和平衡障碍、疼痛、抑郁、慢性疾病和缺乏运动有关。虽然肥胖可能会增加跌倒的风险有多种可能的机制，但令人惊讶的是，关于这两种健康状况如何相互作用的研究很少。此外，正在进行的研究 现有的主要是跨部门的，提供了相互矛盾的结果。更深入地了解肥胖和跌倒是如何相互作用的，将有助于更好地识别老年人跌倒的风险，并可能导致预防跌倒的新策略。本文提出的研究旨在使用一个具有全国代表性的大型数据集，前瞻性地检查肥胖是否与跌倒风险增加有关，并研究哪些临床因素可能起中介作用。 这段关系。我们还将探讨这种关系是否会受到性别、种族/民族和社会经济地位等因素的影响。然后，我们将使用另一个具有全国代表性的数据集来分析肥胖者和非肥胖者与跌倒相关的医疗费用是否有所不同。从拟议工作中获得的知识将有助于更好地了解肥胖症对老年人生活的影响，并使公共卫生能够更好地应对老龄化、肥胖症人口的健康需求。

DESCRIPTION (provided by applicant): Obesity is a complex condition that can affect several facets of functioning. Previous studies have found that obesity is associated with a higher prevalence of several chronic disease conditions, lower quality of life and impaired mobility in older adults. However, one component of physical functioning that has not been well studied in relationship to obesity is risk of falls. Falls and injuries related to falling are a very importan health concern in the older population. Falls can result in significant morbidity, loss of functionl independence and death. On a societal level, injuries related to falls contribute substantially to health care costs, leading to billions of dollars of expenditures each year. Although both obesity and falls are very prevalent conditions in older adults, there is very limited understanding as to how these two conditions may interact. Interestingly, there are a number of potential mechanisms through which obesity could influence the risk of falls. Prior work has identified several patient-related risk factors for falls in older adults including mobility and balance impairment, pain, depression, chronic medical conditions and physical inactivity. Previous work has also shown that obesity is associated with increased mobility and balance impairment, pain, depression, chronic medical conditions and physical inactivity. While there are multiple plausible mechanisms through which obesity could increase the risk of falling, there have been surprisingly few studies of how these two health conditions interact. Further, the studies that are available are largely cross-sectional and provide conflicting results. A deeper understanding of how obesity and falling interact would allow better identification of seniors at risk for falls, an could potentially lead to novel strategies to prevent falls. The studies proposed herein are designed to use a large, nationally representative dataset to prospectively examine whether obesity is associated with increased risk of falls, and to study which clinical factors may mediate this relationship. We will also explore whether this relationship is modified by factors such as sex, race/ethnicity, and socioeconomic status. We will then use another nationally representative dataset to analyze whether the medical costs associated with fall injuries are different in obese vs. the non-obese. The knowledge gained from the proposed work will allow for better understanding of the impact of obesity on the lives of older adults and permit better informed public health response to the health needs of an aging, obese population.