Osteoporosis International

, Volume 27, Issue 7, pp 2231–2240 | Cite as

Lower leg muscle density is independently associated with fall status in community-dwelling older adults

  • A. W. Frank-WilsonEmail author
  • J. P. Farthing
  • P. D. Chilibeck
  • C. M. Arnold
  • K. S. Davison
  • W. P. Olszynski
  • S. A. KontulainenEmail author
Original Article



Muscle density is a risk factor for fractures in older adults; however, its association with falls is not well described. After adjusting for biologically relevant confounding factors, a unit decrease in muscle density was associated with a 17 % increase in odds of reporting a fall, independent of functional mobility.


Falls are the leading cause of injury, disability, and fractures in older adults. Low muscle density (i.e., caused by muscle adiposity) and functional mobility have been identified as risk factors for incident disability and fractures in older adults; however, it is not known if these are also independently associated with falls. The purpose of this study was to explore the associations of muscle density and functional mobility with fall status.


Cross-sectional observational study of 183 men and women aged 60–98 years. Descriptive data, including a 12-month fall recall, Timed Up and Go (TUG) test performance, lower leg muscle area, and density. Odds ratio (OR) of being a faller were calculated, adjusted for age, sex, body mass index, general health status, diabetes, and comorbidities.


Every mg/cm3 increase in muscle density (mean 70.2, SD 2.6 mg/cm3) independently reduced the odds of being a faller by 19 % (OR 0.81 [95 % CI 0.67 to 0.97]), and every 1 s longer TUG test time (mean 9.8, SD 2.6 s) independently increased the odds by 17 % (OR 1.17 [95 % CI 1.01 to 1.37]). When both muscle density and TUG test time were included in the same model, only age (OR 0.93 [95 % CI 0.87 to 0.99]) and muscle density (OR 0.83 [95 % CI 0.69 to 0.99]) were independently associated with fall status.


Muscle density was associated with fall status, independent of functional mobility. Muscle density may compliment functional mobility tests as a biometric outcome for assessing fall risk in well-functioning older adults.


Fall risk Functional mobility Muscle adiposity Myosteatosis pQCT 



This research could not have been possible without the benevolence and altruism of the CaMOs study volunteers. We would like to recognize Saskatoon CaMOs Coordinator Jola Thingvold, as well as Chantal Kawalilak, Juliegh Clarke, Megan Labas, Emma Burke, and Christopher Bespflug for their assistance with the recruitment and data collection. We would also like to acknowledge Claudie Berger for her assistance with CaMOs data, and the CaMOs Research Group for the study approval.

Compliance with ethical standard

Conflicts of interest


Funding sources

A Canadian Institutes of Health Research Saskatchewan Regional Partnership Program (CIHR-RPP) Doctoral Award supports A.W. Frank-Wilson. This work was supported in part by S.A. Kontulainen’s CIHR-RPP New Investigator Award, and funding from the Saskatchewan Health Research Foundation, and Canadian Foundation for Innovation (CFI 16935) and a CIHR Operating Grant (MOP98002).


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2016

Authors and Affiliations

  1. 1.College of KinesiologyUniversity of SaskatchewanSaskatoonCanada
  2. 2.School of Physical TherapyUniversity of SaskatchewanSaskatoonCanada
  3. 3.University of VictoriaVictoriaCanada
  4. 4.Saskatoon Osteoporosis and CaMOs CentreSaskatoonCanada
  5. 5.College of MedicineUniversity of SaskatchewanSaskatoonCanada

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