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Lower gastrocnemius muscle stiffness, derived from elastography, is an independent factor for falls in older adults

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Abstract

Background and aims

It is well known that components of sarcopenia (i.e., decreased muscle strength and mass) are related to falls in older adults. However, the possible effects of changes in muscle quality on falls have not been identified. This study aimed to evaluate the changes in muscle quality reflected by muscle stiffness derived from shear-wave elastography (SWE) and its association with falls in older adults.

Methods

A total of 101 geriatric outpatients were included in the study. Assessments of physical performance, muscle strength (handgrip strength), muscle mass (muscle ultrasonography and bioelectrical impedance analysis), and muscle stiffness of the medial head of gastrocnemius (GCM) in relaxation and passive stretching were performed. The history of falls in the previous year was questioned and recorded.

Results

The median (25–75 percentiles) age of participants was 73 (69–77) years, and 66.3% (n = 67) were female. According to fall history, participants were divided into non-fallers and fallers groups, and 72 (71.3%) and 29 (28.7%) participants were in each group, respectively. The median muscle stiffness of (Emean) the GCM in passive stretching was significantly lower in the fallers group (p < 0.001), and it was significantly correlated with the number of falls in the previous year (r: – 0.274, p: 0.010). In regression analyses, the Emean value of GCM in passive stretching was significantly associated with falls independent of confounders (OR: 0.944, 95% CI 0.90–0.98, p = 0.010).

Discussion and conclusion

This is the first study to reveal the relationship between falls and SWE-defined lower GCM stiffness independently of muscle mass and strength.

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Acknowledgements

The authors especially thank ‘Mindray Biomedical Shenzhen’ for their unconditional support.

Funding

This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Hakan Baş and Arzu Okyar Baş have equally contributed to the article, and both authors are first authors.

Authors and Affiliations

  1. Department of Radiology, Ankara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Yenimahalle, Ankara, Turkey

    Hakan Baş

  2. Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey

    Arzu Okyar Baş, Serdar Ceylan, Merve Güner, Meltem Koca, Merve Hafızoğlu, Zeynep Şahiner, Yelda Öztürk, Cafer Balcı, Burcu Balam Doğu, Mustafa Cankurtaran & Meltem Gülhan Halil

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  1. Hakan Baş
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Contributions

AOB, HB, and MGH equally contributed to the conception and design of the research; AOB, HB, MG, SC, and MK equally contributed to the acquisition and analysis of the data; AOB, HB, YO, MH, ZŞ, BBD, and MC equally contributed to the interpretation of the data; AOB, HB, and MGH critically revised the manuscript and drafted the manuscript. All authors agree to be fully accountable for ensuring the integrity and accuracy of the work and read and approved the final manuscript.

Corresponding author

Correspondence to Hakan Baş.

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The authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the study, and the study's ethics approval was taken from the Hacettepe University Department of Medicine clinical research ethics committee (decision number: 2022/18-47).

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Baş, H., Okyar Baş, A., Ceylan, S. et al. Lower gastrocnemius muscle stiffness, derived from elastography, is an independent factor for falls in older adults. Aging Clin Exp Res 35, 2979–2986 (2023). https://doi.org/10.1007/s40520-023-02605-6

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  • DOI: https://doi.org/10.1007/s40520-023-02605-6

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