Background: The decline in skeletal muscle in old age is a factor in the development of functional limitations. Objective: The objective of this study was to assess if there is a correlation between muscle mass based on bioelectrical impedance analysis (BIA) detection and the fall incidence in nursing home residents and to examine the risk factors for falling in nursing home residents. Methods: This prospective cohort study was part of a longitudinal study on nutritional issues in 52 nursing homes in Antwerp (Belgium) from October 2007 to April 2008. Two hundred and seventy-six people aged 65 years and older were included. Each subject was assessed with BIA, the timed get-up-and-go test, the Katz score, the Mini Nutritional Assessment – Short Form and the 36-Item Short Form Health Survey. The primary outcome parameter was fall incidence during the study. Results: The prevalence of sarcopenia varied from 24.3 to 81.5% depending on which definition was used. No association was found between BIA-derived muscle mass and fall incidence. Logistic regression analysis showed that gait speed (odds ratio 1.029; p = 0.003) and mental health (odds ratio 0.981; p = 0.015) are significantly associated with fall incidence in nursing homes. A receiver operating characteristic curve showed that none of the BIA-derived muscle parameters are good predictors of the risk of falling. Conclusions: This study shows that there is no association between sarcopenia based on BIA and fall incidence and that BIA-derived muscle mass has no additional value in predicting fall incidents compared to the timed get-up-and-go test.

Keywords:
Elderly, Sarcopenia, Falls
1.
Cruz-Jentoft AJ, Landi F, Topinkova E, Michel JP: Understanding sarcopenia as a geriatric syndrome. Curr Opin Clin Nutr Metab Care 2010;13:1–7.
2.
Newman AB, Kupelian V, Visser M, et al: Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc 2003;51:1602–1609.
3.
Otaka Y: Muscle and bone health as a risk factor of fall among the elderly. Sarcopenia and falls in older people (in Japanese). Clin Calcium 2008;18:761–766.
4.
Baumgartner RN, Koehler KM, Gallagher D, et al: Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 1998;147:755–763.
5.
Janssen I, Heymsfield SB, Ross R: Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 2002;50:889–896.
6.
Haentjens P, Lamraski G, Boonen S: Costs and consequences of hip fracture occurrence in old age: an economic perspective. Disabil Rehabil 2005;27:1129–1141.
7.
Roubenoff R: Origins and clinical relevance of sarcopenia. Can J Appl Physiol 2001;26:78–89.
8.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al: Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39:412–423.
9.
Janssen I, Heymsfield SB, Baumgartner RN, Ross R: Estimation of skeletal muscle mass by bioelectrical impedance analysis. J Appl Physiol 2000;89:465–471.
10.
Janssen I, Ross R: Linking age-related changes in skeletal muscle mass and composition with metabolism and disease. J Nutr Health Aging 2005;9:408–419.
11.
Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW: Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963;185:914–919.
12.
Kaiser MJ, Bauer JM, Ramsch C, et al: Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009;13:782–788.
13.
Contopoulos-Ioannidis DG, Karvouni A, Kouri I, Ioannidis JP: Reporting and interpretation of SF-36 outcomes in randomised trials: systematic review. BMJ 2009;338: a3006.
14.
Ware JE Jr, Gandek B: Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol 1998;51:903–912.
15.
Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff R: Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 2004;159:413–421.
16.
Podsiadlo D, Richardson S: The timed ‘Up & Go’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142–148.
17.
Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701–1707.
18.
Landi F, Liperoti R, Fusco D, et al: Prevalence and risk factors of sarcopenia among nursing home older residents. J Gerontol A Biol Sci Med Sci 2012;67:48–55.
19.
Rösler A, Lehmann F, Krause T, Wirth R, von Renteln-Kruse W: Nutritional and hydration status in elderly subjects: clinical rating versus bioimpedance analysis. Arch Gerontol Geriatr 2010;50:e81–e85.
20.
Abellan van Kan G: Epidemiology and consequences of sarcopenia. J Nutr Health Aging 2009;13:708–712.
21.
Tichet J, Vol S, Goxe D, Salle A, Berrut G, Ritz P: Prevalence of sarcopenia in the French senior population. J Nutr Health Aging 2008;12:202–206.
22.
Vandewoude MF: Nutritional assessment in oncogeriatrics (in Dutch). Tijdschr Gerontol Geriatr 2010;41:214–220.
23.
Melton LJ 3rd, Khosla S, Riggs BL: Epidemiology of sarcopenia. Mayo Clin Proc 2000;75(suppl):S10–S12, discussion S2–S3.
24.
American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention: Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001;49:664–672.
25.
Wickham C, Cooper C, Margetts BM, Barker DJ: Muscle strength, activity, housing and the risk of falls in elderly people. Age Ageing 1989;18:47–51.
26.
Visser M, Goodpaster BH, Kritchevsky SB, et al: Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci 2005;60:324–333.
© 2012 S. Karger AG, Basel
2012
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