Objective: The prevalence of obesity by fat percentage has seen a steady increase in older adults in recent years, secondary to increases in fat mass in body composition, even in healthy aging. Malnutrition is a common geriatric syndrome with serious clinical outcomes. Increases in fat mass and waist circumference with healthy aging should not prevent the risk of malnutrition from being masked. Malnutrition is often ignored in obese older people due to low BMI cut-off values in many screening tests. The present study seeks to raise awareness of the need to assess the frequency of undernutrition and related factors in obese older adults. Methods: The data of 2013 community-dwelling patients aged ≥ 60 years who applied to a university geriatrics outpatient clinic between April 2012 and November 2022 were analyzed retrospectively, of which 296 were found to be obese based on fat percentage and were included in the study. Demographic data and the presence of any geriatric syndromes were obtained retrospectively from the patient files, functional status was assessed using the KATZ Activities of Daily Living (ADL) Scale and the LAWTON-BRODY Instrumental Activities of Daily Living Scale (IADL); frailty was screened using FRAIL-scale; and the sample was assessed for malnutrition using the Mini Nutritional Assessment-Short Form (MNA-SF), with undernutrition defined as an MNA-SF score of $$\le 11.$$≤ 11 . The patients’ fat percentage and weight were measured using a bioimpedance analyzer. Fatty obesity was defined using the Zoico methodology (fat percentage $$\ge$$≥ 27.3% for males, $$\ge$$≥ 40.7% for females) $$,$$, handgrip strength (HGS) was measured using a hand dynamometer, and probable sarcopenia was defined as low HGS based on regional cut-off values (35 kg for males, 20 kg for females). Results: The mean age of the 296 fatty obese older adults (102 males/194 females) was 74.4 + 6.5 years, and the median fat was 42.2% (27.4–59.5). Undernutrition was detected in 19.6% of the patients based on MNA-SF screening. A univariate analysis revealed age, sex, educational status, daily physical activity status, depression, difficulty in swallowing, chewing difficulty, probable sarcopenia, number of chronic diseases, and IADL to be associated with undernutrition, while a multivariate logistic regression analysis revealed depression [OR = 3.662, 95% CI (1.448–9.013), p = 0.005] and daily physical activity status [OR:0.601, 95% CI (0.417–0.867), p = 0.006] to be independently associated with malnutrition in obese older adults based on fat percentage. Conclusion: The present study clarifies the significance of undernutrition in obese older adults also in our country, and recommends undernutrition screening to be carried out, by fat percentage, on obese older adults, especially with depression and low daily physical activity.

Purpose: Falls are a common public health problem in older adults regarding increased morbidity, mortality, and healthcare costs. Determining the factors associated with falls is of utmost importance for detecting at-risk people. We present a field study conducted to examine the prevalence of falls and the associated factors among community-dwelling older adults. Methods: In this population-based cross-sectional study, we included adults aged >60 years living in the Fatih District of the Istanbul Province between November 2014-May 2015, through a simple random sampling method. We noted age, sex, falls, fear of falling, number of diseases and medications, the presence of diabetes, hypertension, dyslipidemia, urinary and fecal incontinence, and chronic pain. Frailty was assessed with the FRAIL questionnaire. Functional capacity was evaluated by Katz’s 6-item ADL and Lawton Brody’s 8-item IADL scales. The European quality-5 dimension (EQ-5D) questionnaire was used for the quality of life assessment. The cognitive status screening was conducted with a Mini-cog test. Depressive mood was evaluated with the Geriatric Depression scale short form (GDS-SF). Malnutrition screening was conducted by the mini-nutritional assessment short form. Handgrip strength (HGS) was measured with a hand dynamometer. Body composition was assessed through a bioimpedance analysis. The 4-meter usual gait speed was recorded. The European Working Group on Sarcopenia in Older People2 (EWSGOP2) criteria was used for the sarcopenia definition. The Romberg and the postural instability tests were evaluated for balance and gait. Continuous variables were expressed as mean±standard deviation or median and interquartile range for descriptive statistics, while categorical variables were expressed as the number and percentages. The differences between groups were determined through an independent sample t-test or Mann-Whitney U test when required. Chi-square and Fisher’s exact tests were applied for categorical variables. A multivariate logistic regression analysis was used to determine the independent factors associated with falls among the factors identified as significant in univariate analyses. Results: The prevalence of falls was 28.5% [mean age: 75.4±7.3 (range: 61–101 years), 53.6% female], and a significant association was identified between falls and the number of diseases and medications, diabetes, chronic pain, frailty, ADL, IADL, and EQ-5D scores, dementia, GDS-SF score and level of ambulation in univariate analyses (p=0.001, 0.030, 0.030, 0.010, 0.004, 0.040, 0.007, 0.003, 0.030 and 0.007, respectively). In the multivariate analysis, positive dementia (OR=3.66, 95% CI=1.40-9.53; p=0.010) and frailty screenings (OR =1.47, 95% CI=1.05-2.06; p=0.020) were identified as associates of falls. Conclusion: Falls were independently associated with positive dementia and frailty screening. These results will help develop specific and tailored precautions for at-risk groups to prevent the negative outcomes of falls.