@article{469044e0d3634f7abe3e5e656f05b9fe,
title = "Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis",
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.",
keywords = "Malnutrition, accidental falls, body mass index, meta-analysis",
author = "Caterina Trevisan and Alessio Crippa and Stina Ek and Welmer, {Anna Karin} and Giuseppe Sergi and Stefania Maggi and Enzo Manzato and Bea, {Jennifer W.} and Cauley, {Jane A.} and Evelyne Decullier and Vasant Hirani and LaMonte, {Michael J.} and Lewis, {Cora E.} and Schott, {Anne Marie} and Nicola Orsini and Debora Rizzuto",
note = "Funding Information: We thank all the authors for their contributions to our work and for sharing unpublished data or other relevant information; in particular, Motasim Badri, Bienvenu Bongue, Margaret Bryan, Caroline Dupr{\'e}, Frances Formiga, Chris Gallagher, Tung-Jung Huang, Sebastiana Kalula, Taro Kojima, Marcella Kwan, Jason Leung, Lewis A. Lipsitz, Amanda E. Nelson, Carlos A. Reyes Ortiz, Alejandro Rodr{\'i}guez-Molinero, David Scott, Sowmya Vasan, J. Petra von Heideken W{\aa}gert, and Jean Woo. The Study of Osteoporotic Fractures was supported by the National Institutes of Health, and the National Institute on Aging (grant numbers: R01 AG005407 , R01 AR35582 , R01 AR35583 , R01 AR35584 , R01 AG005394 , R01 AG027574 , R01 AG027576 , and R01 AG026720 ). The WHI program was supported by the National Heart, Lung, and Blood Institute , National Institutes of Health , U.S. Department of Health and Human Services , through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. The authors also thank the WHI investigators and staff for their dedication, and the study participants for making the program possible. Short List of WHI Investigators: Program Office (National Heart, Lung, and Blood Institute, Bethesda, MD): Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller; Clinical Coordinating Center (Fred Hutchinson Cancer Research Center, Seattle, WA): Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg; Investigators and Academic Centers: JoAnn E. Manson (Brigham and Women's Hospital, Harvard Medical School, Boston, MA); Barbara V. Howard (MedStar Health Research Institute/Howard University, Washington, DC); Marcia L. Stefanick (Stanford Prevention Research Center, Stanford, CA); Rebecca Jackson (The Ohio State University, Columbus, OH); Cynthia A. Thomson (University of Arizona, Tucson/Phoenix, AZ); Jean Wactawski-Wende (University at Buffalo, Buffalo, NY); Marian Limacher (University of Florida, Gainesville/Jacksonville, FL); Jennifer Robinson (University of Iowa, Iowa City/Davenport, IA); Lewis Kuller (University of Pittsburgh, Pittsburgh, PA); Sally Shumaker (Wake Forest University School of Medicine, Winston-Salem, NC); Robert Brunner (University of Nevada, Reno, NV); and Karen L. Margolis (University of Minnesota, Minneapolis, MN). Women's Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston-Salem, NC) Mark Espeland. Funding Information: We thank all the authors for their contributions to our work and for sharing unpublished data or other relevant information; in particular, Motasim Badri, Bienvenu Bongue, Margaret Bryan, Caroline Dupr?, Frances Formiga, Chris Gallagher, Tung-Jung Huang, Sebastiana Kalula, Taro Kojima, Marcella Kwan, Jason Leung, Lewis A. Lipsitz, Amanda E. Nelson, Carlos A. Reyes Ortiz, Alejandro Rodr?guez-Molinero, David Scott, Sowmya Vasan, J. Petra von Heideken W?gert, and Jean Woo. The Study of Osteoporotic Fractures was supported by the National Institutes of Health, and the National Institute on Aging (grant numbers: R01 AG005407, R01 AR35582, R01 AR35583, R01 AR35584, R01 AG005394, R01 AG027574, R01 AG027576, and R01 AG026720). The WHI program was supported by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. The authors also thank the WHI investigators and staff for their dedication, and the study participants for making the program possible. Short List of WHI Investigators: Program Office (National Heart, Lung, and Blood Institute, Bethesda, MD): Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller; Clinical Coordinating Center (Fred Hutchinson Cancer Research Center, Seattle, WA): Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg; Investigators and Academic Centers: JoAnn E. Manson (Brigham and Women's Hospital, Harvard Medical School, Boston, MA); Barbara V. Howard (MedStar Health Research Institute/Howard University, Washington, DC); Marcia L. Stefanick (Stanford Prevention Research Center, Stanford, CA); Rebecca Jackson (The Ohio State University, Columbus, OH); Cynthia A. Thomson (University of Arizona, Tucson/Phoenix, AZ); Jean Wactawski-Wende (University at Buffalo, Buffalo, NY); Marian Limacher (University of Florida, Gainesville/Jacksonville, FL); Jennifer Robinson (University of Iowa, Iowa City/Davenport, IA); Lewis Kuller (University of Pittsburgh, Pittsburgh, PA); Sally Shumaker (Wake Forest University School of Medicine, Winston-Salem, NC); Robert Brunner (University of Nevada, Reno, NV); and Karen L. Margolis (University of Minnesota, Minneapolis, MN). Women's Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston-Salem, NC) Mark Espeland. Publisher Copyright: {\textcopyright} 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine",
year = "2019",
month = may,
doi = "10.1016/j.jamda.2018.10.027",
language = "English (US)",
volume = "20",
pages = "569--582.e7",
journal = "Journal of the American Medical Directors Association",
issn = "1525-8610",
publisher = "Elsevier Inc.",
number = "5",
}