Original Article

Analysis of Fall Injuries by Body Mass Index

Authors: Jun Ren, PhD, Amanda Waclawczyk, MPH, Doug Hartfield, MPH, Shicheng Yu, PhD, Xiangyu Kuang, BS, Hongrui Zhang, BS, Hasanat Alamgir, PhD

Abstract

Objective: To examine the association of body mass index (BMI) and fall injuries.

Methods: Data were derived from the 2010 Behavioral Risk Factor Surveillance System and included subjects aged 45 years and older from Texas. The outcome was self-reported falls that resulted in injury to the respondents. Analysis of fall injuries by BMI was conducted and standard errors, 95% confidence intervals (CIs), and coefficients of variation were reported. Complex sample multivariate Poisson regression was used to examine the association of BMI and fall injuries.

Results: A total of 18,077 subjects were surveyed in 2010, and 13,235 subjects were aged 45 years old and older. The mean BMI was higher (29.94 vs 28.32 kg/m 2 ) among those who reported fall injuries compared with those who did not. The fall injuries reported by obese respondents (relative risk [RR] 1.67) were found to be significantly ( P = 0.031) higher compared with normal-weight respondents in the multivariate regression. Other risk factors that had significant association with fall injuries (when adjusted for BMI) were activity limitations (RR 5.00, 95% CI 3.36–7.46) compared with no limitations, and not having formal employment (homemaker: RR 2.68, 95% CI 1.33–5.37; unable to work: RR 5.01, 95% CI 1.87–13.29; out of work and students: RR 3.21, 95% CI 1.41–7.29) compared with the employed population.

Conclusions: There is a significant association between obesity and fall injuries in adults aged 45 years old and older in Texas. Interventions in fall prevention, although generally targeted at present to older adults, also should take into account the weight status of the subjects.

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References

1. Catenacci VA, Hill JO, Wyatt HR. The obesity epidemic. Clin Chest Med 2009;30:415-444.
 
2. Centers for Disease Control and Prevention. Obesity and overweight for professionals: data and statistics DNPAO. http://www.cdc.gov/obesity/data/index.html. Published April 27, 2012. Accessed April 29, 2013.
 
3. Jackson JE, Doescher MP, Jerant AF, et al. A national study of obesity prevalence and trends by type of rural county. J Rural Health 2005;21:140-148.
 
3a. Centers for Disease Control and Prevention. Obesity: halting the epidemic by making health easier. At a glance 2011. http://www.cdc.gov/chronicdisease/resources/publications/aag/obesity.htm. Accessed April 8, 2014.
 
4. World Health Organization. What are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls? http://www.euro.who.int/__data/assets/pdf_file/0018/74700/E82552.pdf. Published March 2004. Accessed March 19, 2014.
 
5. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Risk factors for falls. http://www.cdc.gov/HomeandRecreationalSafety/pdf/steadi/risk_factors_for_falls.pdf. Accessed March 19, 2014.
 
6. Wu X, Lockhart TE, Yeoh HT. Effects of obesity on slip-induced fall risks among young male adults. J Biomech 2012;45:1042-1047.
 
7. Hills AP, Hennig EM, Byrne NM, et al. The biomechanics of adiposity--structural and functional limitations of obesity and implications for movement. Obes Rev 2002;3:35-43.
 
8. Himes CL, Reynolds SL. Effect of obesity on falls, injury, and disability. J Am Geriatr Soc 2012;60:124-129.
 
9. Matter KC, Sinclair SA, Hostetler SG, et al. A comparison of the characteristics of injuries between obese and non-obese inpatients. Obesity (Silver Spring) 2007;15:2384-2390.
 
10. Corbeil P, Simoneau M, Rancourt D, et al. Increased risk for falling associated with obesity: mathematical modeling of postural control. IEEE Trans Neural Syst Rehabil Eng 2001;9:126-136.
 
11. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System. http://www.cdc.gov/brfss. Accessed April 29, 2013.
 
12. Centers for Disease Control and Prevention. Overweight and obesity: defining overweight and obesity. http://www.cdc.gov/obesity/adult/defining.html. Accessed March 19, 2014.
 
13. Fjeldstad C, Fjeldstad AS, Acree LS, et al. The influence of obesity on falls and quality of life. Dyn Med 2008;7:4.
 
14. Finkelstein EA, Chen H, Prabhu M, et al. The relationship between obesity and injuries among U.S. adults. Am J Health Promot 2007;21:460-468.
 
15. Xiang H, Smith GA, Wilkins JR 3rd, et al. Obesity and risk of nonfatal unintentional injuries. Am J Prev Med 2005;29:41-45.
 
16. Jorstad EC, Hauer K, Becker C, et al. Measuring the psychological outcomes of falling: a systematic review. J Am Geriatr Soc 2005;53:501-510.
 
17. Roe B, Howell F, Riniotis K, et al. Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall. J Clin Nurs 2009;18:2261-2272.
 
18. Mosenthal AC, Livingston DH, Elcavage J, et al. Falls: epidemiology and strategies for prevention. J Trauma 1995;38:753-756.
 
19. Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006;35:ii37-ii41.
 
20. Tinetti ME, Speechley M, Ginter SF, et al. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701-1707.
 
21. Tinetti ME. Preventing falls in elderly persons. N Engl J Med 2003;348:42-49.
 
22. See R, Abdullah SM, McGuire DK, et al. The association of differing measures of overweight and obesity with prevalent atherosclerosis: the Dallas Heart Study. J Am Coll Cardiol 2007;50:752-759.
 
23. Stevens JA, Mack KA, Paulozzi LJ, et al. Self-reported falls and fall-related injuries among persons aged 9or =65 years--United States, 2006. J Safety Res 2008;39:345-349.
 
24. Breiding MJ, Black MC, Ryan GW. Prevalence and risk factors of intimate partner violence in eighteen U.S. states/territories, 2005. Am J Prev Med 2008;34:112-118.
 
25. Park H, Sprince NL, Jensen C, et al. Health risk factors and occupation among Iowa workers. Am J Prev Med 2001;21:203-208.
 
26. Fan ZJ, Bonauto DK, Foley MP, et al. Underreporting of work-related injury or illness to workers’ compensation: individual and industry factors. J Occup Environ Med 2006;48:914-922.