The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program

Evaluation of quality of life in the elderly who have fallen

Background/Aim: Approximately 30% of older adults fall at least once per year; consequently, falls are a significant public health concern in the elderly. The most common outcomes are fractures, immobility, high morbidity, and mortality rates. In recent years, quality of life (QoL) is used as a criterion to guide social policies for the elderly. The high prevalence of falls can have serious consequences on the QoL of older people, resulting in prolonged hospitalization, institutionalization, need for care, social isolation, anxiety, and depression. Therefore, it is essential to understand the effect of falls on QoL and influencing factors. In light of this study’s results, it is intended to provide recommendations for social policy that will protect the elderly from falls and maintain their high QoL. This study aimed to determine the QoL and the factors affecting the elderly who have fallen. Methods: The research was a cross-sectional study. The study sample consisted of 90 elderly individuals who applied to the hospital due to falls. The inclusion criteria were being 65 years of age or older, applying to the hospital's emergency department, orthopedic or orthopedic surgery clinic due to a fall, not having passed 6 months from the date of discharge, and agreeing to participate in the study voluntarily. Data were collected through face-to-face interviews in January–June 2021 using the purposive sampling method. The Elderly Introduction Form was used to obtain sociodemographic data of the participants, as well as data on falls and their experiences after falls. The Quality of Life Scale for the Elderly was used to determine QoL. The student’s t-test was used to compare two categorical variables. ANOVA was used for more than two variables, and logistic regression analysis was also applied. Results: QoL levels were classified as poor, fair, and good, and 58.9% of the participants were found to have a fair QoL. In addition, according to the scale’s total score average of 3.17 (0.473), the general quality of life was found to be fair for all participants. According to the t-test and ANOVA results, the QoL was higher for those with higher education levels and those living with their spouses (P˂0.05). The QoL was low in those who had fractures, had surgery, were hospitalized for more than 4 days, and had chronic diseases (P˂0.05). In the regression analysis model, age, economic status, and the number of drugs used were effective on QoL. Conclusion: The quality of life was poor in the elderly who experienced fractures and were hospitalized. Balance-enhancing exercises in the elderly can prevent falls and associated complications. Low education level, chronic illness, and drug use reduced the quality of life. For education, literacy courses and lifelong learning programs can be applied to the elderly. For diseases, healthy aging policies can be implemented.

Serum Irisin level is associated with fall risk, muscle strength, and cortical porosity in postmenopausal women

BACKGROUND

Irisin plays a role in bone-muscle crosstalk, but the relationship between the serum irisin level and bone microarchitecture remains unknown.

OBJECTIVE

This study aimed to investigate the relationships between serum irisin level and fall risk, muscle strength, bone mineral density (BMD), and bone microarchitecture among Chinese postmenopausal women.

METHODS

In all 138 postmenopausal women, handgrip strength, short physical performance battery (SPPB), and the timed up-and-go test were performed to evaluate muscle strength, physical performance, and fall risk, respectively. The serum irisin was measured. High-resolution peripheral quantitative computed tomography (HR-pQCT) was performed to acquire volumetric BMD and bone microarchitecture. Bivariate analysis was used to explore relationships between serum irisin level and muscle strength and HR-pQCT parameters. Univariate and multivariate linear regression analyses were performed to determine associations between serum irisin level and vBMD and cortical porosity (Ct.Po).

RESULTS

All participants had a median serum irisin level of 3.91 μg/ml. Participants with high fall risk had significantly lower serum irisin levels than those with low fall risk (2.22 μg/ml vs. 4.16 μg/ml, p=0.024). Irisin level was positively related to handgrip strength (rs=0.185, p=0.030) and SPPB performance. In univariate linear regression, serum irisin level was positively associated with cortical volumetric BMD (Ct.vBMD, radius: standardized β=0.184, p=0.031; tibia: standardized β=0.242, p=0.004), but it had no significant associations with Ct.vBMD after multivariate adjustment. After adjusting by age, height, serum sclerostin level, and body fat ratio, only Ct.Po at the distal radius had a significantly negative association with serum irisin level (standardized β=-0.276, p=0.003).

CONCLUSION

Postmenopausal women with lower serum irisin levels have a higher fall risk, weaker muscle strength, and higher cortical porosity. Moreover, serum irisin level has a positive association with Ct.vBMD, but it is affected by factors such as age.

Osteosarcopenia: A Narrative Review on Clinical Studies

Osteosarcopenia (OS) is defined by the concurrent presence of osteopenia/osteoporosis and sarcopenia. The pathogenesis and etiology of OS involve genetic, biochemical, mechanical, and lifestyle factors. Moreover, an inadequate nutritional status, such as low intake of protein, vitamin D, and calcium, and a reduction in physical activity are key risk factors for OS. This review aims to increase knowledge about diagnosis, incidence, etiology, and treatment of OS through clinical studies that treat OS as a single disease. Clinical studies show the relationship between OS and the risk of frailty, falls, and fractures and some association with Non-communicable diseases (NCDs) pathologies such as diabetes, obesity, and cardiovascular disease. In some cases, the importance of deepening the related mechanisms is emphasized. Physical exercise with adequate nutrition and nutritional supplementations such as proteins, Vitamin D, or calcium, represent a significant strategy for breaking OS. In addition, pharmacological interventions may confer benefits on muscle and bone health. Both non-pharmacological and pharmacological interventions require additional randomized controlled trials (RCT) in humans to deepen the synergistic effect of exercise, nutritional interventions, and drug compounds in osteosarcopenia.