Effects of Body Adipose Distribution on Fall Risks and Motor Learning Among Older Adults with Obesity
Ahn, Jiyun
Citations
Abstract
Falls are a leading cause of accidents among older adults. Although overall obesity has been associated with an increased fall risk in older adults, it remains unknown whether the distribution of fat mass (or obesity type: android vs. gynoid) affects fall risk and motor learning capacity following perturbation training similarly or differently in older adults with obesity, particularly compared to lean older adults. The primary objective of this dissertation project was to investigate if and how obesity type affects fall risk and motor learning ability among older adults with obesity relative to lean older adults. Two specific aims were pursued: 1) to examine whether older adults with android or gynoid obesity react to a novel and unexpected standing-slip on a treadmill differently compared to lean older adults, and 2) to determine if obesity type affects the capability of adaptation to repeated standing-slips in older adults with obesity with respect to lean older adults. Lean older adults (n = 12) and older adults with gynoid (n = 11) and android (n = 8) obesity enrolled in this dissertation project. They experienced repeated standing-slips on a treadmill. Full-body kinematics were collected through a motion capture system. Primary (dynamic gait stability) and secondary (slip distance, recovery step latency, length, duration, and speed) outcomes were compared between groups to fulfill the research questions. Older adults with android obesity exhibited more impaired dynamic gait stability during the first standing-slip than lean older adults and older adults with gynoid obesity, likely due to the delayed detection of the slip perturbation induced by the mechanical disadvantage of android fat distribution. However, there was no difference in dynamic gait stability during slip between lean older adults and older adults with gynoid obesity, suggesting that body fat concentrated around the lower body may not compromise reactive balancing ability following the novel standing-slip. In motor learning analysis, older adults with android obesity showed limited ability to adjust COM position and velocity, while those in lean and gynoid obesity groups exhibited better COM control. The recovery step duration decreased and step speed increased in both android and gynoid obesity groups, while the lean group showed increased step duration and decreased step speed, indicating distinct compensatory or strategic adaptation during repeated slips. This study provided meaningful insights into preventing falls in older adults with obesity from two perspectives. First, the findings highlighted that fat distribution, rather than obesity alone, may more accurately predict fall risk, facilitating the effective and accurate identification of individuals with a high fall risk based on their fat distribution. Second, the findings could inform the design of perturbation-based fall prevention programs for older adults with obesity.
