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Gluteal muscle fatty infiltration, fall risk, and mobility limitation in older women with urinary incontinence: a pilot study

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Skeletal Radiology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 05 October 2022

Abstract

Objective

Gluteal muscle quality influences risk of falling and mobility limitation. We sought (1) to compare gluteal muscle fatty infiltration (FI) between groups of older women with urinary incontinence (UI) at risk for falling (at-risk group) and not at risk for falling (not-at-risk group), and (2) to determine correlation of gluteal FI with Timed Up and Go (TUG) and Short Physical Performance Battery (SPPB) performance.

Materials and methods

Prospective pilot study of gluteal FI on pelvis MRI for 19 women with UI, aged ≥ 70 years. A musculoskeletal radiologist selected axial T1-weighted MR images; then, two blinded medical student research assistants analyzed gluteal FI by quantitative fuzzy C-means segmentation. TUG and SPPB tests were performed. TUG ≥ 12 s defined participants as at risk for falling. Descriptive, correlation, and reliability analyses were performed.

Results

Mean age, 76.3 ± 4.8 years; no difference for age or body mass index (BMI) between the at-risk (n = 5) versus not-at-risk (n = 14) groups. SPPB score (p = 0.013) was lower for the at-risk group (6.4 ± 3.1) than for the not-at-risk group (10.2 ± 1.9). Fuzzy C-means FI-%-estimate differed between the at-risk group and the not-at-risk group for bilateral gluteus medius/minimus (33.2% ± 15.6% versus 19.5% ± 4.1%, p = 0.037) and bilateral gluteus maximus (33.6% ± 15.6% versus 19.7% ± 6.9%, p = 0.047). Fuzzy C-means FI-%-estimate for bilateral gluteus maximus had significant (p < 0.050) moderate correlation with age (rho =  − 0.64), BMI (rho = 0.65), and TUG performance (rho = 0.52). Fuzzy C-means FI-%-estimates showed excellent inter-observer and intra-observer reliability (intraclass correlation coefficient, ≥ 0.892).

Conclusion

Older women with UI at risk for falling have greater levels of gluteal FI and mobility limitation as compared to those not at risk for falling.

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Funding

This study was supported with funding in support of Dr. Tatiana V.D. Sanses from the University of Maryland Building Interdisciplinary Research Careers in Women’s Health program (K12 HD43489), University of Maryland Claude D. Pepper Older Americans Independence Center (P30 AG028747), Georgetown-Howard Universities Center for Clinical and Translational Science (UL1TR001409), and the National Institute on Aging (R03 AG053281). Dr. Alice S. Ryan was supported by a Senior Research Career Scientist Award from the Department of Veterans Affairs Rehabilitation Research & Development.

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Authors and Affiliations

  1. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 22 S. Greene Street, Baltimore, MD, 21201, USA

    Derik L. Davis

  2. University of Maryland School of Medicine, Baltimore, MD, USA

    Andrew Roberts & Rodolfo Calderon

  3. Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC, USA

    Shihyun Kim & Tatiana V. D. Sanses

  4. Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Alice S. Ryan

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  1. Derik L. Davis
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Correspondence to Derik L. Davis.

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Davis, D.L., Roberts, A., Calderon, R. et al. Gluteal muscle fatty infiltration, fall risk, and mobility limitation in older women with urinary incontinence: a pilot study. Skeletal Radiol 52, 47–55 (2023). https://doi.org/10.1007/s00256-022-04132-3

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