Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

Caterina Trevisan, Alessio Crippa, Stina Ek, Anna Karin Welmer, Giuseppe Sergi, Stefania Maggi, Enzo Manzato, Jennifer W. Bea, Jane A. Cauley, Evelyne Decullier, Vasant Hirani, Michael J. LaMonte, Cora E. Lewis, Anne Marie Schott, Nicola Orsini, Debora Rizzuto

Research output: Contribution to journalReview article

10 Scopus citations

Abstract

Objectives: To evaluate the association between nutritional status, defined on the basis of a multidimensional evaluation, and body mass index (BMI) with the risk of falls and recurrent falls in community-dwelling older people. Design: Systematic literature review and meta-analysis. Setting and Participants: Community-dwelling older adults. Measures: A systematic literature review was conducted on prospective studies identified through electronic and hand searches until October 2017. A random effects meta-analysis was used to evaluate the relative risk (RR) of experiencing falls and recurrent falls (≥2 falls within at least 6 months) on the basis of nutritional status, defined by multidimensional scores. A random effects dose-response meta-analysis was used to evaluate the association between BMI and the risk of falls and recurrent falls. Results: People who were malnourished or those at risk for malnutrition had a pooled 45% higher risk of experiencing at least 1 fall than were those well-nourished (9510 subjects). Increased falls risk was observed in subjects malnourished versus well-nourished [RR 1.64, 95% confidence interval (CI) 1.18-2.28; 3 studies, 8379 subjects], whereas no substantial results were observed for risk of recurrent falls. A U-shaped association was detected between BMI and the risk for falls (P <.001), with the nadir between 24.5 and 30 (144,934 subjects). Taking a BMI of 23.5 as reference, the pooled RR of falling ranged between 1.09 (95% CI 1.04-1.15) for a BMI of 17, to 1.07 (95% CI 0.92-1.24) for a BMI of 37.5. No associations were observed between BMI and recurrent falls (120,185 subjects). Conclusions/Implications: The results of our work suggest therefore that nutritional status and BMI should be evaluated when assessing the risk for falls in older age.

Original languageEnglish (US)
Pages (from-to)569-582.e7
JournalJournal of the American Medical Directors Association
Volume20
Issue number5
DOIs
StatePublished - May 2019

Keywords

  • Malnutrition
  • accidental falls
  • body mass index
  • meta-analysis

ASJC Scopus subject areas

  • Nursing(all)
  • Health Policy
  • Geriatrics and Gerontology

Fingerprint Dive into the research topics of 'Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis'. Together they form a unique fingerprint.

  • Cite this

    Trevisan, C., Crippa, A., Ek, S., Welmer, A. K., Sergi, G., Maggi, S., Manzato, E., Bea, J. W., Cauley, J. A., Decullier, E., Hirani, V., LaMonte, M. J., Lewis, C. E., Schott, A. M., Orsini, N., & Rizzuto, D. (2019). Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Journal of the American Medical Directors Association, 20(5), 569-582.e7. https://doi.org/10.1016/j.jamda.2018.10.027