Background: Falling is an important public health issue because of its prevalence and severe consequences. Evaluating muscle performance is important when assessing fall risk. The study aimed to identify factors [namely muscle capacity (strength, quality, and power) and spatio-temporal gait attributes] that best discriminate between fallers and non-fallers in older adults. The 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 body composition, mean grip strength, spatio-temporal parameters, and muscle capacity of fallers and non-fallers. Muscle quality was calculated as the ratio of maximum strength to fat-free mass. Mean handgrip and power were also controlled by fat-free mass. We performed univariate analysis, logistic regression, and ROC curves. Results: The falling patients had lower muscle quality, muscle mass-controlled power, and mean weighted handgrip than the non-faller. Results showing that lower muscle quality increases fall risk (effect size = 0.891). Logistic regression confirmed muscle quality as a significant predictor (p < .001, OR = 0.82, CI [0.74; 0.89]). ROC curves demonstrated muscle quality as the most predictive factor of falling (AUC = 0.794). Conclusion: This retrospective study showed that muscle quality is the best predictor of fall risk, above spatial and temporal gait parameters. Our results underscore muscle quality as a clinically meaningful assessment and may be a useful complement to other assessments for fall prevention in the aging population.

Sarcopenia, characterised by ageing-related loss of muscle mass and strength, is a major contributor to functional decline and increased fall risk in older

Objective: Sarcopenia is a progressive muscular disease. The European Working Group on Sarcopenia in Older People revised protocols to include the F-A-C-S procedure. Sarcopenia severity is assessed by physical performance tests. However, these tests can be influenced by various factors. Ultrasound offers a more objective method for measuring muscle mass and assessing sarcopenia severity. This study aims to determine reliable ultrasound measurements for objectively evaluating sarcopenia severity in older adults. Design: A prospective study was conducted, assessing 200 patients over 75, with sarcopenia identified via SARC-F questionnaire, grip strength, and chair stand test. Ultrasound measured muscle thickness in the rectus femoris and other muscles. Comparative analyses divided patients into nonsevere sarcopenia and severe sarcopenia groups, with receiver operating characteristic curves and logistic regression to evaluate ultrasound measurements’ discriminative power. Results: Muscle thickness, particularly of the rectus femoris, significantly correlated with sarcopenia severity. Ultrasound measurements accurately discriminated sarcopenia severity with an area under the receiver operating characteristic curve (AUC) of 0.629. Logistic regression confirmed rectus femoris thickness as a predictive measure for severe sarcopenia. Conclusions: Ultrasound measurement of rectus femoris muscle thickness is a promising tool for diagnosing sarcopenia severity, enhancing early identification and improving management strategies for the elderly.

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.

Fragility fractures constitute a major global health burden and often result from falls. However, clinical care for fragility fractures is currently organized separately from fall prevention services leading to gaps in integrated care delivery. This joint position paper from the European Geriatric Medicine Society, the Fragility Fracture Network, the World Falls Prevention Society, the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, the International Osteoporosis Foundation, the European Union of Medical Specialists-Geriatric Medicine Section, and the International Association of Gerontology and Geriatrics–European Region highlights the critical need for integrated falls and fracture prevention, with a focus on evidence-based clinical practice, knowledge dissemination, education, policy strategies, and research. We outline existing guidelines on fall and fracture prevention, with particular emphasis on how fracture risk assessment can be incorporated into fall prevention services and on integrating fall assessment into fracture prevention services. We advocate that future implementation guidelines place greater emphasis on fully integrated models of care. Moreover, training and education programs should be designed to encourage interdisciplinary collaboration among healthcare professionals. Integrated fall and fracture prevention services should be recognized as a public health priority and incorporated into national strategies for healthy aging, supported by adequate, dedicated, and sustainable resources including evidence-based exercise provision. Finally, future research should focus on evaluating the (cost) effectiveness of integrated care models and examining their practical implementation in real-world settings.