Ghorbanzadeh Maryam, Bakhtiari Afsaneh, Hajian-Tilaki Karimollah, Abbaszadeh-Amirdehi Maryam
Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
Social Determinants of Health Research Center, Health Research Institute, Babol university of Medical Sciences, Babol, Iran.
BMC Geriatr. 2025 Jul 2;25(1):442. doi: 10.1186/s12877-025-06097-z.
Dynapenia and frailty are known to be strong predictors of decreased function and increased mortality in the older adults. However, limited research on the co-occurrence of these factors and the different frailty domains makes their relationship with fall risk poorly understood. The aim of this study was to investigate the relationship between fall risk, dynapenia phenotypes, and frailty domains in the older adults.
In this cross-sectional study of 400 outpatients aged 65+, without major functional, cognitive, or serious comorbid issues, fall risk was assessed using the Berg Balance Scale. Frailty was evaluated via the TFI across physical, psychological, and social domains. Handgrip dynamometry determined dynapenia, classifying the participants into robust, dynapenic, abdominally obese, and dynapenic-obese phenotypes. To examine the associations between frailty, dynapenia, and fall risk, we applied a comprehensive, multi-layered analytical strategy covering all plausible combinations. Associations were analyzed using univariate and multivariate regressions in SPSS v23.
In univariate analyses, fall risk was markedly higher among older adults with dynapenia (59.2%) or multidimensional frailty (60%), and peaked when both conditions coexisted (67.9%). Multivariate models demonstrated that dynapenia (OR = 2.75; 95% CI: 1.48-5.12) and frailty (OR = 2.56; 95% CI: 1.39-4.70) were independently associated with increased fall risk, with a pronounced effect when both were present (OR = 20.45; 95% CI: 6.02-46.69). Among frailty components, only physical (OR = 1.39; 95% CI: 1.19-1.62) and social frailty (OR = 1.38; 95% CI: 1.03-1.84) remained significant predictors in adjusted analyses. Interaction effects revealed that combining dynapenia with these domains further heightened the risk. A clear dose-response pattern emerged: fall risk escalated from 3.24-fold (95% CI: 1.48-3.09) with two frailty domains plus dynapenia, to 7.27-fold (95% CI: 3.46-7.29) when all three domains co-occurred.
Dynapenia and frailty, particularly in physical and social domains, independently and jointly elevate fall risk in older adults. Their co-occurrence demonstrates a dose-dependent effect, underscoring the need for integrated assessments to better identify and manage those at highest risk.
肌肉减少症和衰弱是老年人功能下降和死亡率增加的有力预测因素。然而，关于这些因素同时出现以及不同衰弱领域的研究有限，这使得它们与跌倒风险的关系尚不清楚。本研究的目的是调查老年人跌倒风险、肌肉减少症表型和衰弱领域之间的关系。
在这项横断面研究中，纳入了400名65岁以上的门诊患者，他们没有严重的功能、认知或严重共病问题，使用伯格平衡量表评估跌倒风险。通过全面衰弱指数（TFI）在身体、心理和社会领域评估衰弱情况。通过握力测量确定肌肉减少症，将参与者分为强壮型、肌肉减少型、腹部肥胖型和肌肉减少肥胖型表型。为了研究衰弱、肌肉减少症和跌倒风险之间的关联，我们应用了一种全面的、多层次的分析策略，涵盖所有可能的组合。使用SPSS v23软件进行单变量和多变量回归分析。
在单变量分析中，患有肌肉减少症（59.2%）或多维衰弱（60%）的老年人跌倒风险明显更高，当这两种情况同时存在时跌倒风险达到峰值（67.9%）。多变量模型表明，肌肉减少症（OR = 2.75；95% CI：1.48 - 5.12）和衰弱（OR = 2.56；95% CI：1.39 - 4.70）与跌倒风险增加独立相关，当两者同时存在时影响更为显著（OR = 20.45；95% CI：6.02 - 46.69）。在衰弱组成部分中，调整分析后只有身体衰弱（OR = 1.39；95% CI：1.19 - 1.62）和社会衰弱（OR = 1.38；95% CI：1.03 - 1.84）仍然是显著的预测因素。交互作用分析表明，肌肉减少症与这些领域相结合会进一步增加风险。出现了明显的剂量反应模式：跌倒风险从两个衰弱领域加肌肉减少症时的3.24倍（95% CI：1.48 - 3.09），增加到三个领域同时存在时的7.27倍（95% CI：3.46 - 7.29）。
肌肉减少症和衰弱，特别是在身体和社会领域，独立且共同增加老年人的跌倒风险。它们的同时出现显示出剂量依赖性效应，强调需要进行综合评估，以更好地识别和管理高危人群。
