Sex-Specific Associations Between Sarcopenia and Obesity Parameters and Falls in Korean Older Adults: A Cross-Sectional Analysis of the Korean Frailty and Aging Cohort Study.

<i>Background and Objectives</i>: Aging is associated with sarcopenia and increased adiposity, which may impair mobility and increase fall risk. Although sarcopenic obesity is associated with an increased fall risk compared with either condition alone, evidence regarding sex-specific associations remains limited. This study aimed to examine the sex-specific associations between sarcopenia, obesity parameters, and falls among older Korean community-dwellers. <i>Materials and Methods</i>: This cross-sectional study analyzed baseline data from the Korean Frailty and Aging Cohort Study, including 2039 participants aged 70-84 years (men, 973; women, 1066). Sarcopenia was defined using the Asian Working Group for Sarcopenia 2025 criteria, and obesity was categorized as general (body mass index and percentage body fat [PBF]) or central obesity (waist circumference [WC] and conicity index [C-index]). Falls were assessed by self-report. Logistic regression analyses were performed after adjusting for potential confounders. <i>Results:</i> Among 2039 participants, 395 (19.4%) reported falls. In the total population, higher PBF and C-index were independently associated with increased fall risk after adjustment. Men showed significantly higher odds of falls with low handgrip strength, high WC, PBF, and C-index than women. In women, only low appendicular skeletal muscle mass index was independently associated with falls. Sarcopenic obesity was not significantly associated with falls in either sex. <i>Conclusions:</i> Although sarcopenic obesity itself was not independently associated with falls in either sex, distinct sex-specific associations were observed between individual components of sarcopenia, obesity, and fall risk among older Korean adults. Reduced muscle strength and central obesity were more strongly associated with falls in men, whereas reduced muscle mass was independently associated with falls in women. These findings suggest that sex-specific approaches targeting muscle function and body composition may be important for fall prevention in aging populations.