Abstract
BackgroundImpaired balance, loss of mobility and falls are major problems associated with changes in muscle in older adults. However, the extent to which muscle composition and related performance measures for different lower limb muscles are associated with falls in older individuals is unclear. This study evaluated lower limb muscle attenuation, intramuscular adipose tissue (IMAT) infiltration and muscle performance in older fallers and non-fallers.MethodsFor this cross-sectional study, fifty-eight community dwelling older individuals (>65 years) were classified into fallers (n = 15) or non-fallers (n = 43). Computed tomography (CT) was used to determine muscle attenuation and intramuscular adipose tissue (IMAT) of multiple thigh and hip muscles. Muscle performance was assessed with isokinetic dynamometry.ResultsFor both groups, Rectus Femoris showed the highest muscle attenuation and lowest IMAT infiltration, and Gluteus Maximus and Gluteus Medius/Minimus muscles had the lowest muscle attenuation and highest IMAT infiltration. Fallers exhibited lower muscle attenuation and higher IMAT infiltration than non-faller participants in most muscles, where the gluteal muscles were the most affected (p < 0.05). Fallers also showed a lower peak hip abduction torque (p < 0.05). There were significant associations (r = 0.31 to 0.53) between joint torques and muscle composition, with the strongest associations between Gluteus Medius/Minimus and hip abduction strength.ConclusionsWhile fallers were generally differentiated from non-fallers by muscle composition, the most affected muscles were the proximal gluteal muscles of the hip joint accompanied by lower hip abduction strength, which may contribute to impaired balance function and increased risk for falls.
Highlights
Impaired balance, loss of mobility and falls are major problems associated with changes in muscle in older adults
Older individuals have lower maximum isokinetic hip abduction torque implicated in lateral balance control than younger adults, and these age-related decrements in strength are greater for older individuals at higher risk for falls than for those at lower fall risk [7,15]
In order to recruit a sample of otherwise healthy community dwelling older individuals that would be able to undergo muscle composition and strength testing procedures without major confounding factors, participants aged 65 years or older were screened over the telephone by the recruitment staff, followed by a medical examination performed by a physician geriatrician
Summary
Loss of mobility and falls are major problems associated with changes in muscle in older adults. The extent to which muscle composition and related performance measures for different lower limb muscles are associated with falls in older individuals is unclear. Protective stepping is normally a commonly used strategy for stabilizing balance balance control [10,12,13,14] In this regard, older individuals have lower maximum isokinetic hip abduction torque implicated in lateral balance control than younger adults, and these age-related decrements in strength are greater for older individuals at higher risk for falls than for those at lower fall risk [7,15]. Arthritic degeneration with older age can affect muscle composition [16], it is conceivable that the age-related reductions in physical activity patterns may impact changes in muscle composition that affect balance and mobility involving the mediolateral direction
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