1
|
Mongold SJ, Georgiev C, Naeije G, Vander Ghinst M, Stock MS, Bourguignon M. Age-related changes in ultrasound-assessed muscle composition and postural stability. Sci Rep 2024; 14:18688. [PMID: 39134635 PMCID: PMC11319795 DOI: 10.1038/s41598-024-69374-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024] Open
Abstract
While the simultaneous degradation of muscle composition and postural stability in aging are independently highly investigated due to their association with fall risk, the interplay between the two has received little attention. Thus, the purpose of this study is to explore how age-related changes in muscle composition relate to postural stability. To that aim, we collected posturography measures and ultrasound images of the dominant Vastus Lateralis and Biceps Brachii from 32 young (18-35 year old) and 34 older (65-85 year old) participants. Muscle properties were quantified with echo-intensity and texture-based metrics derived from gray-level co-occurrence matrix analysis, and postural stability with the variability of the center of pressure during bipedal stance tasks. Ultrasound parameters revealed that young muscle possessed lower echo-intensity and higher homogeneity compared to the elderly. Echo-intensity and muscle thickness, and several texture-based parameters possessed outstanding young versus older classification performance. A canonical correlation analysis demonstrated a significant relationship between ultrasound and postural measures only within the young group (r = 0.53, p < 0.002), where those with 'better' muscle composition displayed larger postural sways. Our results indicate that, in older individuals, postural stability and muscle composition, two common fall risk factors, are unrelated. In view of this decoupling, both may contribute independently to fall risk. Furthermore, our data support the view that texture-based parameters provide a robust alternative to echo-intensity in providing markers of muscle composition.
Collapse
Affiliation(s)
- Scott J Mongold
- Laboratory of Neurophysiology and Movement Biomechanics, UNI-ULB Neuroscience Institute Université libre de Bruxelles (ULB), 1070, Brussels, Belgium.
| | - Christian Georgiev
- Laboratory of Neurophysiology and Movement Biomechanics, UNI-ULB Neuroscience Institute Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
| | - Gilles Naeije
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- Centre de Référence Neuromusculaire, Department of Neurology, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
| | - Marc Vander Ghinst
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- Service d'ORL et de Chirurgie Cervico-Faciale, CUB Hôpital Erasme, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
| | - Matt S Stock
- School of Kinesiology and Rehabilitation Sciences, University of Central Florida, Orlando, Florida, 32816, USA
| | - Mathieu Bourguignon
- Laboratory of Neurophysiology and Movement Biomechanics, UNI-ULB Neuroscience Institute Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, UNI-ULB Neuroscience Institute, Université libre de Bruxelles (ULB), 1070, Brussels, Belgium
- BCBL, Basque Center on Cognition, Brain and Language, 20009, San Sebastian, Spain
| |
Collapse
|
2
|
Michel E, Zory R, Guerin O, Prate F, Sacco G, Chorin F. Assessing muscle quality as a key predictor to differentiate fallers from non-fallers in older adults. Eur Geriatr Med 2024:10.1007/s41999-024-01020-y. [PMID: 39096327 DOI: 10.1007/s41999-024-01020-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/01/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Falling is an important public health issue because of its prevalence and severe consequences. Evaluating muscle performance is important when assessing fall risk. The study aimed to identify factors [namely muscle capacity (strength, quality, and power) and spatio-temporal gait attributes] that best discriminate between fallers and non-fallers in older adults. The hypothesis is that muscle quality, defined as the ratio of muscle strength to muscle mass, is the best predictor of fall risk. METHODS 184 patients were included, 81% (n = 150) were women and the mean age was 73.6 ± 6.83 years. We compared body composition, mean grip strength, spatio-temporal parameters, and muscle capacity of fallers and non-fallers. Muscle quality was calculated as the ratio of maximum strength to fat-free mass. Mean handgrip and power were also controlled by fat-free mass. We performed univariate analysis, logistic regression, and ROC curves. RESULTS The falling patients had lower muscle quality, muscle mass-controlled power, and mean weighted handgrip than the non-faller. Results showing that lower muscle quality increases fall risk (effect size = 0.891). Logistic regression confirmed muscle quality as a significant predictor (p < .001, OR = 0.82, CI [0.74; 0.89]). ROC curves demonstrated muscle quality as the most predictive factor of falling (AUC = 0.794). CONCLUSION This retrospective study showed that muscle quality is the best predictor of fall risk, above spatial and temporal gait parameters. Our results underscore muscle quality as a clinically meaningful assessment and may be a useful complement to other assessments for fall prevention in the aging population.
Collapse
Affiliation(s)
- Emeline Michel
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France.
- Université Côte d'Azur, LAMHESS, Nice, France.
| | - Raphael Zory
- Université Côte d'Azur, LAMHESS, Nice, France
- Institut Universitaire de France (IUF), Paris, France
| | - Olivier Guerin
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
- Université Côte d'Azur, INSERM, CNRS, Nice, France
| | - Frederic Prate
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
| | - Guillaume Sacco
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
- Université Côte d'Azur, UPR 7276 CoBTek, Nice, France
| | - Fréderic Chorin
- Department of Geriatric Medicine, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Clinique Gériatrique de Soins Ambulatoires, 06003, Nice, France
- Université Côte d'Azur, LAMHESS, Nice, France
| |
Collapse
|
3
|
Yokoyama H, Kitano Y. Oral Frailty as a Risk Factor for Fall Incidents among Community-Dwelling People. Geriatrics (Basel) 2024; 9:54. [PMID: 38667521 PMCID: PMC11050511 DOI: 10.3390/geriatrics9020054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/04/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Identifying older adults with a high risk of falling and providing them with appropriate intervention are vital measures for preventing fall incidents. Scholars report that oral frailty, a decline in oral function, is related to physical function; thus, it bears a potential association with fall risks. This study aimed to investigate the relationship between fall incidents and the status of physical and oral frailty among a sample of residents in Osaka Prefecture. SUBJECTS AND METHODS This study targeted community-dwelling people aged 50 years and older who responded to an annual questionnaire survey using a health app for 2 consecutive years, namely, 2020 and 2021. This study analyzed responses from 7591 (62 ± 7 years) participants and determined the status of their oral frailty and comprehensive and physical frailty using the Kihon Checklist. RESULTS In the 2020 and 2021 surveys, 17% and 19% of the participants exhibited oral frailty and experienced a fall in the previous year, respectively. Logistic regression analysis demonstrated that oral frailty (adjusted odds ratio: 1.553) and physical frailty as well as low levels of awareness of frailty were significant explanatory variables of the occurrence of fall incidents during the subsequent year. CONCLUSIONS Future studies are required to elucidate the mechanisms by which oral frailty induces fall incidents.
Collapse
Affiliation(s)
- Hisayo Yokoyama
- Research Center for Urban Health and Sports, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi, Osaka 558-8585, Japan;
- Department of Environmental Physiology for Exercise, Graduate School of Medicine, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi, Osaka 558-8585, Japan
| | - Yugo Kitano
- Research Center for Urban Health and Sports, Osaka Metropolitan University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka-shi, Osaka 558-8585, Japan;
| |
Collapse
|
4
|
Vendrami C, Shevroja E, Gonzalez Rodriguez E, Gatineau G, Elmers J, Reginster J, Harvey NC, Lamy O, Hans D. Muscle parameters in fragility fracture risk prediction in older adults: A scoping review. J Cachexia Sarcopenia Muscle 2024; 15:477-500. [PMID: 38284511 PMCID: PMC10995267 DOI: 10.1002/jcsm.13418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/01/2023] [Accepted: 11/28/2023] [Indexed: 01/30/2024] Open
Abstract
Half of osteoporotic fractures occur in patients with normal/osteopenic bone density or at intermediate or low estimated risk. Muscle measures have been shown to contribute to fracture risk independently of bone mineral density. The objectives were to review the measurements of muscle health (muscle mass/quantity/quality, strength and function) and their association with incident fragility fractures and to summarize their use in clinical practice. This scoping review follows the PRISMA-ScR guidelines for reporting. Our search strategy covered the three overreaching concepts of 'fragility fractures', 'muscle health assessment' and 'risk'. We retrieved 14 745 references from Medline Ovid SP, EMBASE, Web of Science Core Collection and Google Scholar. We included original and prospective studies on community-dwelling adults aged over 50 years that analysed an association between at least one muscle parameter and incident fragility fractures. We systematically extracted 17 items from each study, including methodology, general characteristics and results. Data were summarized in tables and graphically presented in adjusted forest plots. Sixty-seven articles fulfilled the inclusion criteria. In total, we studied 60 muscle parameters or indexes and 322 fracture risk ratios over 2.8 million person-years (MPY). The median (interquartile range) sample size was 1642 (921-5756), age 69.2 (63.5-73.6) years, follow-up 10.0 (4.4-12.0) years and number of incident fragility fractures 166 (88-277). A lower muscle mass was positively/not/negatively associated with incident fragility fracture in 28 (2.0), 64 (2.5) and 10 (0.2 MPY) analyses. A lower muscle strength was positively/not/negatively associated with fractures in 53 (1.3), 57 (1.7 MPY) and 0 analyses. A lower muscle function was positively/not/negatively associated in 63 (1.9), 45 (1.0 MPY) and 0 analyses. An in-depth analysis shows how each single muscle parameter was associated with each fragility fractures subtype. This review summarizes markers of muscle health and their association with fragility fractures. Measures of muscle strength and function appeared to perform better for fracture risk prediction. Of these, hand grip strength and gait speed are likely to be the most practical measures for inclusion in clinical practice, as in the evaluation of sarcopenia or in further fracture risk assessment scores. Measures of muscle mass did not appear to predict fragility fractures and might benefit from further research, on D3-creatine dilution test, lean mass indexes and artificial intelligence methods.
Collapse
Affiliation(s)
- Colin Vendrami
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
- Internal Medicine Unit, Department of Internal MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Enisa Shevroja
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Elena Gonzalez Rodriguez
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Guillaume Gatineau
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Jolanda Elmers
- University Library of Medicine, Faculty of Biology and MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Jean‐Yves Reginster
- WHO Collaborating Center for Public Health Aspects of Musculo‐Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health EconomicsUniversity of LiègeLiègeBelgium
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Olivier Lamy
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
- Internal Medicine Unit, Department of Internal MedicineLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - Didier Hans
- Interdisciplinary Center of Bone Diseases, Rheumatology Unit, Department of Bone and JointLausanne University Hospital and University of LausanneLausanneSwitzerland
| |
Collapse
|
5
|
Baş H, Okyar Baş A, Ceylan S, Güner M, Koca M, Hafızoğlu M, Şahiner Z, Öztürk Y, Balcı C, Doğu BB, Cankurtaran M, Halil MG. Lower gastrocnemius muscle stiffness, derived from elastography, is an independent factor for falls in older adults. Aging Clin Exp Res 2023; 35:2979-2986. [PMID: 37907664 DOI: 10.1007/s40520-023-02605-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/20/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND AND AIMS It is well known that components of sarcopenia (i.e., decreased muscle strength and mass) are related to falls in older adults. However, the possible effects of changes in muscle quality on falls have not been identified. This study aimed to evaluate the changes in muscle quality reflected by muscle stiffness derived from shear-wave elastography (SWE) and its association with falls in older adults. METHODS A total of 101 geriatric outpatients were included in the study. Assessments of physical performance, muscle strength (handgrip strength), muscle mass (muscle ultrasonography and bioelectrical impedance analysis), and muscle stiffness of the medial head of gastrocnemius (GCM) in relaxation and passive stretching were performed. The history of falls in the previous year was questioned and recorded. RESULTS The median (25-75 percentiles) age of participants was 73 (69-77) years, and 66.3% (n = 67) were female. According to fall history, participants were divided into non-fallers and fallers groups, and 72 (71.3%) and 29 (28.7%) participants were in each group, respectively. The median muscle stiffness of (Emean) the GCM in passive stretching was significantly lower in the fallers group (p < 0.001), and it was significantly correlated with the number of falls in the previous year (r: - 0.274, p: 0.010). In regression analyses, the Emean value of GCM in passive stretching was significantly associated with falls independent of confounders (OR: 0.944, 95% CI 0.90-0.98, p = 0.010). DISCUSSION AND CONCLUSION This is the first study to reveal the relationship between falls and SWE-defined lower GCM stiffness independently of muscle mass and strength.
Collapse
Affiliation(s)
- Hakan Baş
- Department of Radiology, Ankara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Yenimahalle, Ankara, Turkey.
| | - Arzu Okyar Baş
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Serdar Ceylan
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Merve Güner
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Meltem Koca
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Merve Hafızoğlu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Zeynep Şahiner
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Yelda Öztürk
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Cafer Balcı
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Burcu Balam Doğu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Cankurtaran
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Meltem Gülhan Halil
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
6
|
Nagae M, Umegaki H, Yoshiko A, Fujita K. Muscle ultrasound and its application to point-of-care ultrasonography: a narrative review. Ann Med 2023; 55:190-197. [PMID: 36538042 PMCID: PMC9788691 DOI: 10.1080/07853890.2022.2157871] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Technological advances of hand-held ultrasound devices and educational programmes for their use, such as point-of-care ultrasonography (POCUS) training, have contributed to the increasing application of these devices in clinical practice. With the greater impact of frailty and sarcopenia in aging societies, attention is being focused on the use of ultrasound for skeletal muscle assessment. In this narrative review, we discuss how ultrasound can be applied to skeletal muscle assessment, especially that of the quadriceps muscle, in clinical practice. Muscle thickness by ultrasound has been shown to have good reliability and validity for the evaluation of muscle size, and echo intensity has been used to evaluate muscle quality. Muscle ultrasound has not only been useful to diagnose sarcopenia in various settings, but has also been validated to predict health-related outcomes such as death and functional disability. Recommended methods for muscle ultrasound was published recently, and the results of future studies are expected to be comparable. Although several challenging issues with muscle ultrasound remain, if it could be incorporated into educational programmes such as POCUS training, more clinicians may be able to use ultrasound for skeletal muscle assessment in the future.KEY MESSAGESThe evolution of hand-held ultrasound devices enables physicians to perform ultrasound at the bedside as part of regular medical examinations.Muscle ultrasound is considered an effective tool for evaluating muscle size and quality, and has been studied in various settings.More clinicians may be able to evaluate skeletal muscle assessment with the development of educational programmes on muscle ultrasound in the future.
Collapse
Affiliation(s)
- Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Akito Yoshiko
- Faculty of Liberal Arts and Sciences, Chukyo University, Aichi, Japan
| | - Kosuke Fujita
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| |
Collapse
|
7
|
Arai H, Nozoe M, Kamiya K, Matsumoto S, Morimoto T. Association Between Skeletal Muscle Mass Index and Falls in Patients With Functional Impairment. Am J Phys Med Rehabil 2023; 102:913-918. [PMID: 37405906 DOI: 10.1097/phm.0000000000002249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
OBJECTIVE This study aimed to assess the association between skeletal muscle mass index and falls in patients with functional impairment. DESIGN This retrospective cohort study was implemented at a convalescent rehabilitation ward. Patients with no measurement of skeletal muscle mass index and bed-ridden patients were excluded from this study. Patients were dichotomized into the low skeletal muscle mass index group and the high skeletal muscle mass index group. The occurrence of fall was assessed according to skeletal muscle mass index groups. RESULTS Of the 327 included patients, 231 (71%) were assigned to the low skeletal muscle mass index group. In total, 66 patients (20%) experienced at least one fall, and a total of 102 falls occurred. The incidence of falls for the low skeletal muscle mass index group was not significantly greater than that for the high skeletal muscle mass index group (4.9 per 1000 patient-days vs. 4.5 per 1000 patient-days, P = 0.9). Low skeletal muscle mass index was not significantly associated with one or more incidents of falls (odds ratio [95% confidence intervals] = 0.6 [0.3-1.17]). CONCLUSIONS This study found that skeletal muscle mass index was not significantly associated with falls in patients undergoing convalescent rehabilitation.
Collapse
Affiliation(s)
- Hideki Arai
- From the Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan (HA, TM); Toyonaka Heisei Hospital, Toyonaka, Osaka, Japan (HA, SM); Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Hyogo, Japan (MN); and Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, Takatsuki, Japan (KK)
| | | | | | | | | |
Collapse
|
8
|
Duque G, Kirk B, Arai H. Strong muscles lead to strong bones: The connection between osteoporosis, sarcopenia, falls and fractures. Bone 2023; 173:116789. [PMID: 37164216 DOI: 10.1016/j.bone.2023.116789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Gustavo Duque
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada; Bone, Muscle & Geroscience Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
| | - Ben Kirk
- Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Victoria, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
9
|
Merchant RA, Chan YH, Ling N, Denishkrshna A, Lim Z, Waters D. Association of physical function and body composition with falls in pre-frail older adults with poor physical performance: A cross-sectional study. Arch Gerontol Geriatr 2023; 109:104957. [PMID: 36780754 DOI: 10.1016/j.archger.2023.104957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/30/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Falls in pre-frail older adults is often attributed to poor physical performance, lower muscle quality and quantity. The aims of our study were to determine (i) demographics, physical function, and body composition in pre-frail older adults with poor physical performance (ii) characteristics of fallers amongst those with poor physical performance and (iii) association of physical function and body composition measures with falls in pre-frail older adults with poor physical performance. METHODS Cross-sectional study of 328 pre-frail community-dwelling older adults ≥ 60 years. Data was collected on demographics, cognition, short physical performance battery (SPPB) and gait speed. Poor physical performance was defined by SPPB ≤ 9, 5x chair-stand time ≥12 s or gait speed <1 m/s. InBody S10 used to measure body composition. RESULTS Mean age 72.51 years, 185(56.4%) females, 276(84.1%) of Chinese ethnicity and 257 (78.4%) had poor physical performance. Within the poor performers, SPPB balance (OR 0.50; 95% CI 0.27-0.92; p = 0.025) and 5x-chair-stand (OR 1.09; 95% CI 1.01-1.18; p = 0.038) in addition to higher body fat percentage, fat mass index, fat mass to fat free mass ratio, all segmental lean masses except for left leg and body cell mass were significantly associated with falls. CONCLUSIONS Longer chair-stand time, lower balance, low muscle and high fat mass are associated with falls in poor performers and could serve as screening tools for those at increased risk of falls. The findings from our study need to be validated prospectively in a larger population study.
Collapse
Affiliation(s)
- Reshma Aziz Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Natalie Ling
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - A Denishkrshna
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zhiying Lim
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Debra Waters
- Department of Medicine/ School of Physiotherapy, University of Otago, Dunedin, New Zealand
| |
Collapse
|