Stages of sarcopenia and the incidence of falls in older women: A prospective study

Abstract

The purpose of the present study was to assess the association between different stages of sarcopenia and the incidence of falls over 18 months in older community-dwelling women. 246 women (68.1 ± 6.2 years) underwent body composition using dual-energy x-ray absorptiometry, knee extensors isokinetic peak torque, and Timed Up-and-Go assessments. The stages of sarcopenia were classified according to the European Working Group on Sarcopenia in Older People. Volunteers were classified into four groups as follows: nonsarcopenia, presarcopenia, sarcopenia, and severe sarcopenia. Participants were tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Cox proportional regressions were conducted. A total of 195 women were followed over the 18-month period. Proportions of each sarcopenia stage were 6.7%, 13.8%, and 12.8% for presarcopenia, sarcopenia, and severe sarcopenia, respectively. The proportion of fallers progressively increased according to the severity of sarcopenia, with 15.4%, 40.7%, and 72% for presarcopenia, sarcopenia, and severe sarcopenia, respectively (X2 = 30.637; p < 0.001). Severe sarcopenia was consistently associated with a higher risk of falls (hazard ratio: 3.843; 95% CI: 1.816–8.131), even after adjustments for age, body mass index, physical activity level, regular use of four or more medications, reduced peripheral sensation, presence of two or more chronic diseases, and history of lower-limbs pain. It is concluded that severe sarcopenia is independently associated with higher incidence of falls in older women. These results provide support for the concept that sarcopenia staging has clinical implications and might be an useful supplement to other routine falls risk assessment tools.