Associations of Obesity Phenotypes with Incident Fall Rates: Results from the Objective Physical Activity and Cardiovascular Health in Older Women (OPACH) Study

Hajin Jang; Carolyn J Crandall; Shweta Gore; Chen Hu; Andrea Z LaCroix; Michael J LaMonte; Longjian Liu; Kerri S Freeland; Jane A Cauley; Marcia L Stefanick; Benjamin T Schumacher; Elsa S Strotmeyer

doi:10.1093/gerona/glag152

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Associations of Obesity Phenotypes with Incident Fall Rates: Results from the Objective Physical Activity and Cardiovascular Health in Older Women (OPACH) Study

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Associations of Obesity Phenotypes with Incident Fall Rates: Results from the Objective Physical Activity and Cardiovascular Health in Older Women (OPACH) Study

Hajin Jang, Carolyn J Crandall, Shweta Gore, Chen Hu, Andrea Z LaCroix, Michael J LaMonte, Longjian Liu, Kerri S Freeland, Jane A Cauley, Marcia L Stefanick, …

The journals of gerontology. Series A, Biological sciences and medical sciences, v 81(7)

10 Jun 2026

DOI: https://doi.org/10.1093/gerona/glag152

PMID: 42271627

Featured in Collection : UN Sustainable Development Goals @ Drexel

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Abstract

Sarcopenia

adiposity

Body Composition

Obesity and sarcopenia may influence fall risk through different mechanisms, but how different phenotypes affect fall rates is unclear, especially among older women. This study examined associations of whole-body obesity, abdominal obesity, and sarcopenic obesity with incident fall rates among community-dwelling older women in the United States. We analyzed data from 4,654 ambulatory women aged ≥63 years in the Objective Physical Activity and Cardiovascular Health study, an ancillary study of the Women's Health Initiative. Whole-body overweight and obesity were defined as body mass index (BMI) 25 to < 30 kg/m2 and ≥30 kg/m2, respectively; abdominal obesity as waist circumference >88 cm; and sarcopenia as grip strength <20 kg. Sarcopenic obesity was defined as the coexistence of obesity (either whole-body or abdominal) and sarcopenia. Falls were recorded using daily calendars over 13 months. Negative binomial regression models estimated associations between obesity phenotypes and monthly fall rates, adjusting for demographic, behavioral, and health-related covariates. Whole-body overweight and obesity were associated with lower fall rates compared to normal BMI (overweight IRR = 0.82, 95% CI = 0.73, 0.92; obesity IRR = 0.76, 95% CI = 0.66, 0.87). Abdominal obesity showed a modest association with reduced fall rates (IRR = 0.87, 95% CI = 0.78, 0.96). In contrast, sarcopenia alone (IRR = 1.44, 95% CI = 1.24, 1.68), and sarcopenic obesity (IRR = 1.20, 95% CI = 1.03, 1.39) were associated with significantly higher fall rates. Our findings underscore the critical role of muscle strength loss, rather than excess adiposity, in fall risk among older women. Future interventions to reduce sarcopenia may reduce fall rates.

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Title: Associations of Obesity Phenotypes with Incident Fall Rates: Results from the Objective Physical Activity and Cardiovascular Health in Older Women (OPACH) Study
Creators: Hajin Jang - University of Pittsburgh
Carolyn J Crandall - University of California, Los Angeles
Shweta Gore - MGH Institute of Health Professions
Chen Hu - University of Pittsburgh
Andrea Z LaCroix - Human Longevity (United States)
Michael J LaMonte - University at Buffalo, State University of New York
Longjian Liu - Drexel University
Kerri S Freeland - University of Pittsburgh
Jane A Cauley - University of Pittsburgh
Marcia L Stefanick - Stanford Health Care
Benjamin T Schumacher - University of Pittsburgh
Elsa S Strotmeyer (Corresponding Author) - University of Pittsburgh
Publication Details: The journals of gerontology. Series A, Biological sciences and medical sciences, v 81(7)
Publisher: Oxford University Press
Number of pages: 8
Grant note: National Institutes of Health: HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C
The WHI OPACH study was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, and HHSN271201100004C, and National Heart, Lung, and Blood Institute grant R01HL105065. This work was supported by the National Institute on Aging R01AG061136 and T32AG000181 to E.S.S.
Resource Type: Journal article
Language: English
Academic Unit: Epidemiology and Biostatistics
Web of Science ID: WOS:001808333300001
Other Identifier: 991022191298304721