Sarcopenia and sarcopenic obesity in Spanish community-dwelling middle-aged and older women: Association with balance confidence, fear of falling and fall risk

Objectives: To analyze the association of sarcopenia, obesity, and sarcopenic obesity (SO) with fear of falling (FoF) and balance confidence in a Spanish sample of middle-aged and older community-dwelling women. Study design and outcome measures: A total of 235 women (69.21 +/- 7.56 years) participated in this study. Body composition (bioelectrical impedance analysis), hand-grip strength, and physical performance (gait speed) were evaluated for the diagnosis of sarcopenia, obesity, and SO. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. The Activities-Specific Balance Confidence Scale (ABC) and the Falls Efficacy Scale-International (FES-I) were employed to assess FoF and balance confidence, respectively. Scores of >26 on the FES-I and <67% on the ABC were used to identify women at risk of falling. The independent associations of sarcopenia, obesity and SO with FoF, balance confidence, and fall risk were evaluated by multivariate linear and logistic regressions, adjusting for potential confounding variables. Results: 27.23% and 18.72% of women presented with sarcopenia and SO, respectively. Gait speed, body mass index (BMI), and fall history were independently associated with ABC score (adjusted-R-2 = 0.152) and fall risk (ABC) (adjusted-R-2 = 0.115). FES-I score was independently associated (adjusted-R-2 = 0.193) with fall history, gait speed, BMI, and depression, which, together with obesity (BMI) and SO, remained independent factors for fall risk measured as FES-I score (adjusted-R-2 = 0.243). Conclusion: In community-dwelling middle-aged and older Spanish women, BMI, gait speed, and fall history were independently associated with FoF, balance confidence, and fall risk. Depression was related only to FoF, and, together with obesity (BMI) and SO, was an independent predictor of fall risk as assessed by the FES-I.