Association of Sonographic Sarcopenia and Falls in Older Adults Presenting to the Emergency Department

Abstract

Background and Objective: To determine the association between point-of-care-ultrasonography (POCUS)-measured sarcopenia and grip strength, as well as the history of prior-year falls among older adults admitted to the emergency department observation unit (EDOU). Materials and Methods: This cross-sectional observational study was conducted over 8 months at a large urban teaching hospital. A consecutive sample of patients who were 65 years or older and admitted to the EDOU were enrolled in the study. Using standardized techniques, trained research assistants and co-investigators measured patients’ biceps brachii and thigh quadriceps muscles via a linear transducer. Grip strength was measured using a Jamar Hydraulic Hand Dynamometer. Participants were surveyed regarding their history of falls in the prior year. Logistic regression analyses assessed the relationship of sarcopenia and grip strength to a history of falls (the primary outcome). Results: Among 199 participants (55% female), 46% reported falling in the prior year. The median biceps thickness was 2.22 cm with an Interquartile range [IQR] of 1.87–2.74, and the median thigh muscle thickness was 2.91 cm with an IQR of 2.40–3.49. A univariate logistic regression analysis demonstrated a correlation between higher thigh muscle thickness, normal grip strength, and history of prior-year falling, with an odds ratio [OR] of 0.67 (95% conference interval [95%CI] 0.47–0.95) and an OR of 0.51 (95%CI 0.29–0.91), respectively. In multivariate logistic regression, only higher thigh muscle thickness was correlated with a history of prior-year falls, with an OR of 0.59 (95% CI 0.38–0.91). Conclusions: POCUS-measured thigh muscle thickness has the potential to identify patients who have fallen and thus are at high risk for future falls.

Keywords

• geriatric
• older adults
• ultrasound
• sarcopenia
• falls
• emergency department