Güner Merve, Boğa İlker, Topuz Semra, Okyar Baş Arzu, Ceylan Serdar, Çöteli Süheyla, Kahyaoğlu Zeynep, Balcı Cafer, Doğu Burcu Balam, Cankurtaran Mustafa, Halil Meltem
Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230, Altındağ, Ankara, Türkiye.
Department of Physiotherapy, Hacettepe University Faculty of Health Sciences, Ankara, Türkiye.
Eur Geriatr Med. 2023 Oct;14(5):1065-1073. doi: 10.1007/s41999-023-00823-9. Epub 2023 Jun 23.
There are many risk factors for falls and sarcopenia has emerged as an important risk factor. Measuring muscle mass is a useful method to determine sarcopenia. Our aim was to determine the difference in muscle mass between older adults with (fallers) and without history of falls (non-fallers) using ultrasonography (US).
Two hundred ten geriatric patients were enrolled. Fall was defined as an event declared by the person who fell. Sarcopenia was defined by EWGSOP2 criteria. Muscle mass was assessed by muscle ultrasonography of five different muscles.
The mean age of the whole study group was 74.1 ± 6.3 years and 58.1% (n = 122) of the total study population was female. Among the participants, 69 patients (31.3%) had a fall history. The sarcopenia ratio was 23.2% in the fallers, and it was 13.7% in the non-fallers, the difference was statistically insignificant (p > 0.05), the measurement of rectus femoris muscle (RF) thickness and cross-sectional area (RFCSA) were significantly smaller among the fallers than non-fallers (p < 0.05). The ROC analysis revealed that RF and RFCSA could determine the history of falls [for RF area under curve (AUC): 0.606, 95% confidence interval (CI) 0.526-0.686, p = 0.010 and for RFCSA AUC: 0.621, 95% CI 0.538-0.704, p = 0.004]. RFCSA was statistically relevant with a history of falls, regardless of age, sex, multimorbidity, incontinence, nutritional status, and frailty status.
Decreased RF and RFCSA determined by muscle US is a potentially modifiable risk factor for falls in older adults. Muscle US may be used for determining the risk of falls in older adults.
跌倒存在多种风险因素，肌肉减少症已成为一个重要的风险因素。测量肌肉量是确定肌肉减少症的一种有用方法。我们的目的是使用超声检查（US）确定有跌倒史（跌倒者）和无跌倒史（非跌倒者）的老年人之间的肌肉量差异。
纳入210名老年患者。跌倒定义为跌倒者自述的事件。肌肉减少症根据EWGSOP2标准定义。通过对五块不同肌肉进行肌肉超声检查来评估肌肉量。
整个研究组的平均年龄为74.1±6.3岁，研究总人口的58.1%（n = 122）为女性。在参与者中，69名患者（31.3%）有跌倒史。跌倒者的肌肉减少症比例为23.2%，非跌倒者为13.7%，差异无统计学意义（p>0.05），跌倒者的股直肌（RF）厚度和横截面积（RFCSA）测量值显著小于非跌倒者（p<0.05）。ROC分析显示，RF和RFCSA可确定跌倒史[RF曲线下面积（AUC）：0.606，95%置信区间（CI）0.526 - 0.686，p = 0.010；RFCSA的AUC：0.621，95%CI 0.538 - 0.704，p = 0.004]。无论年龄、性别、多种疾病、失禁、营养状况和虚弱状态如何，RFCSA与跌倒史在统计学上相关。
肌肉超声检查确定的RF和RFCSA降低是老年人跌倒的一个潜在可改变风险因素。肌肉超声检查可用于确定老年人跌倒的风险。
