The Relationship Between Obesity and Falling in Older Adults

描述（由申请人提供）：肥胖是一种复杂的疾病，可以影响几个方面的功能。先前的研究发现，肥胖与老年人几种慢性疾病的高患病率、生活质量下降和活动能力受损有关。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是老年人非常重要的健康问题。跌倒可导致严重的发病率、丧失功能独立性和死亡。在社会层面上，与跌倒有关的伤害在很大程度上增加了医疗保健费用，每年导致数十亿美元的支出。尽管肥胖和跌倒在老年人中非常普遍，但人们对这两种情况如何相互作用的理解非常有限。有趣的是，有许多潜在的机制可以通过肥胖影响跌倒的风险。先前的工作已经确定了老年人跌倒的几个与患者相关的风险因素，包括活动能力和平衡障碍、疼痛、抑郁、慢性疾病和缺乏身体活动。先前的研究也表明，肥胖与活动能力增强、平衡能力受损、疼痛、抑郁、慢性疾病和缺乏运动有关。虽然有多种看似合理的机制表明肥胖会增加跌倒的风险，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却很少。此外，这些研究

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. PUBLIC HEALTH RELEVANCE: The proposed work will prospectively examine the relationship between obesity and risk of falls in older adults. We will then examine whether there are clinical factors that might explain the relationship between obesity and risk of falls. Finally we will study whether health care costs related to fall injuries differ in the obese vs. the non-obese.