Frailty is associated with a history of falls among mobility-limited older adults-cross-sectional multivariate analysis from the BIOFRAIL study

Abstract

Aim: To identify differences in characteristics between mobility-limited older adults with a history of falls and those at risk of falling but who have not yet fallen.

Findings: Frailty and muscle strength were characteristics distinguishing between older adults with a history of falls and those absent of falls despite an increased risk of falling.

Message: Frailty should be incorporated alongside handgrip strength (HGS) and sit-to-stand (STS) tests into routine evaluations of mobility-limited older adults referred for fall assessment.

Purpose: We aimed to identify differences in characteristics between mobility-limited older adults with a history of falls and those at risk of falling, and to identify the parameter with the strongest predictive value on the risk of falling.

Methods: Data included anthropometry, HGS, 30-s and 5-reps STS tests, maximal isometric knee extensor strength, gait speed (6 m), postural balance (tandem test), and muscle mass (BIA). Frailty was assessed using the Clinical Frailty Scale (CFS) and sarcopenia was evaluated according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) guidelines. Outcomes of falls (past year), and depression (Geriatric Depression Scale 15) were self-reported.

Results: Totally, 505 mobility-limited older adults (mean age 79.7 ± 6.3 years, 64.8% females) were included. Of these, 400 (79.2%) had experienced one or more falls within the past year (fallers), while 105 (20.8%) had not experienced a fall (at risk). Patients with experienced falls were more likely to feel depressed, had reduced handgrip strength, and reduced performance in both STS tests compared to those who had not fallen. Frailty was the strongest individual parameter associated with a history of prior falls, even after adjusting for covariates such as depression and 30-s STS (aOR 3.80; 95% CI 1.70-8.50).

Conclusions: Present study identified frailty as a key factor independently associated with a history of falls in this population. Additionally, handgrip strength and STS performance were key characteristics distinguishing between older adults with a history of falls within the past 12 months and those at risk of falling.

Trial registration: NCT05795556.

Keywords: Falls; Mechanical muscle function; Mobility-limited patients; Muscle strength; Old age.