Assessing Muscle Quality as a Key Predictor of Fall Risk in Older Adults

Background Falling is an important public health issue because of its high frequency and severe consequences. Evaluating muscle performance is important when assessing the risk of falling. The aim of this study was to identify factors (namely muscle functionality and spatio-temporal gait attributes) that best discriminate between fallers and non-fallers in older adults. The main hypothesis is that muscle quality, defined as the ratio of muscle strength to muscle mass, is the best predictor of fall risk. Methods 184 patients were included, 81% (n = 150) were women and the mean age was 73.6 ± 6.83 years. We compared the body composition, mean handgrip strength, spatio-temporal parameters and muscle function (strength, quality and power) of fallers and non-fallers. Muscle quality was calculated as the ratio of maximum strength to fat-free mass. Mean handgrip strength and power were also weighted by fat-free mass. Results The falling patients had lower muscle quality, weighted power and mean weighted handgrip strength than the non-falling patients. The univariate analysis, logistic regression and ROC curves enabled us to highlight the importance of muscle quality rather than quantity. The ROC curves have shown that muscle quality is the most predictive factor of falling. Conclusion This study of older adults showed that muscle quality is the best predictor of fall risk, more than muscle mass and spatial and temporal gait parameters. Our results confirm that muscle quality is a clinically meaningful assessment and may be a useful complement to other assessments for fall prevention in the ageing population.