The objective of this study is to evaluate the potential of rectus femoris shear wave elastography (RF-SWE) in assessing its impact on frailty and physical performance parameters, using a comparative analysis with rectus femoris muscle thickness (RF-MT). A total of 149 participants aged 60 and above were included in this research. All participants underwent a comprehensive geriatric assessment, frailty status assessment (using the frailty phenotype [FFP]), and evaluation of physical performance parameters (utilizing the short physical performance battery score [SPPB] and handgrip strength measurement). RF-MT and RF-SWE were measured by a radiologist with participants in a prone and relaxed position. The mean age of participants was 73.8 ± 6.5, with 61.7% (n = 92) being female. Participants were divided into 2 groups based on their frailty status, with 40 (26.8%) identified as frail and 109 (73.2%) as non-frail. RF-MT exhibited a significant correlation with frailty and the SPPB, while RF-SWE did not exhibit significant associations except for handgrip strength. In regression analyses, RF-MT was found to be significantly and independently associated with physical frailty. The optimal cutoff value for RF-MT was determined to be ≤ 17.74 (area under the ROC curve [AUC], 0.752; 95% CI 0.675-0.819; p < 0.001). In contrast, RF-SWE did not show a significant relationship. RF-MT is more strongly associated with physical performance and physical frailty than the muscle quality assessed by RF-SWE. Measuring RF-MT, rather than RF-SWE, proves to be an effective tool for predicting frailty in the geriatric population.
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