The role of sarcopenia, frailty, and geriatric syndromes in predicting fall frequency in geriatric patients

Falls are a significant public health issue that can lead to injury, disability, and even death. Falls occur due to multifactorial causes, and assessing and identifying fall risk factors can help prevent future falls by focusing on reversible risk factors. The aim of this study was to identify the incidence of falls and risk factors that predict falls in community-dwelling geriatric individuals based on comprehensive geriatric assessment, balance tests, and assessment of muscle by ultrasound. A total of 64 patients who had previously completed their initial measurements at the Geriatric Outpatient Clinic of HUTF Hospital were included in our study. During index study, patients were thoroughly evaluated, and balance and ultrasound measurements of muscle were conducted. The mean ± SD time interval between the index study and control visit was 30.4 (±6.0) months. The incidence of falls was 42.1%. It was observed that the fallers were at a higher risk in terms of malnutrition, frailty, and sarcopenia compared to non-fallers. Fallers had lower limits of anterior and posterior stability in balance tests, significantly decreased rectus femoris muscle thickness, and significantly increased external oblique muscle thickness compared to non-fallers. Regression analysis revealed that fall risk was associated with the limits of anterior and posterior stability in balance tests and the gastrocnemius pennation angle measured by muscle ultrasound. Regardless of age and gender, an increase in the limits of anterior and posterior stability reduced fall risk, while an increase in the gastrocnemius pennation angle increased fall risk. A variety of methods have been used in clinical practice to evaluate balance since balance impairment is known to increase the risk of falls. Our findings suggest that clinicians should perform balance tests in order to identify fall risk and prevent falls. Additionally, the use of muscle ultrasound, particularly for measuring and monitoring the thickness of lower limb and abdominal muscles, can help identify individuals at risk of falling and take preventive measures.