Research Article
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Yaşlıda düşme riskini tahmin etmede osteosarkopeni ve dengenin rolü

Year 2022, Volume: 3 Issue: 2, 60 - 65, 25.08.2022

Funda Datlı Yakaryılmaz Neslihan Cansel

https://doi.org/10.29228/anatoljhr.62246

Abstract

Amaç: Çalışmamızda geriatri polikliniğine başvuran yaşlılarda düşme riskinin tahmin edilmesinde denge ve osteosarkopeni varlığının rolünü araştırmayı amaçlanmaktadır.
Yöntem: Çalışmaya dâhil edilen 205 katılımcının kemik mineral yoğunluğu çift enerjili X-ray absorpsiyometri (DXA) ile kas kütlesi bioempedans analizi (BIA) ile denge ve yürüme Tinetti denge ve yürüyüş değerlendirmesi (TDYD) ile değerlendirildi. Hastalar BIA ve DXA verilerine göre 4 gruba ayrılmıştır.
Bulgular: Tüm katılımcıların 27‘sinde (%13.2) osteosarkopeni saptandı. Osteosarkopeni osteosarkopeni grubunda diğer gruplara göre düşme sayısı daha yüksek iken baldır çevresi, EKK ve TDYD skorları anlamlı düzeyde düşüktü. TDYD skoruna göre her üç hastadan birinde düşme riski yüksek saptandı. Düşme gelişmesinde TDYD skoru (p<0.001, OR=1.912 [1.596-2.291]) ve baldır çevresi (p=0.013, OR=1.159 [1.032-1.301]) bağımsız değişkenler olarak bulundu.
Sonuçlar: Bu çalışmada, yaşlı hastalarda, osteoporoz/osteopeni ve sarkopeninin yaygın olduğu, denge, el kavram kuvveti, baldır çevresi ve yaşın düşmeyi belirleyen prediktörler olduğu bulundu. Yaşlanan küresel nüfusla birlikte hem sarkopeni hem de osteoporozun daha yaygın hale geleceği ve dolayısıyla düşmeninde artış göstereceği düşünüldüğünde, bulgularımız, yaşlı hastaların takip ve tedavisinde belirlenen parametrelerin düşme riskinin erken tanınmasında kolaylıkla kullanılabileceğini göstermiştir.

Keywords

denge yaşlı düşme osteosarkopeni

References

  • Bahat, G., Tufan, A., Tufan, F., Kilic, C., Akpinar, T. S., Kose, M., ... & Cruz-Jentoft, A. J. (2016). Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clinical Nutrition, 35(6), 1557-1563.
  • Balogun, S., Winzenberg, T., Wills, K., Scott, D., Callisaya, M., Cicuttini, F., ... & Aitken, D. (2019). Prospective associations of osteosarcopenia and osteodynapenia with incident fracture and mortality over 10 years in community-dwelling older adults. Archives of Gerontology and Geriatrics, 82, 67-73.
  • Bohannon, R. W. (2019). Grip strength: an indispensable biomarker for older adults. Clinical Interventions in Aging, 14, 1681-1691
  • Compston, J. E., McClung, M. R., & Leslie, W. D. (2019). Osteoporosis. Lancet, 393(10169), 364–376.
  • Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., ... & Zamboni, M. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16-31.
  • Cruz-Jentoft, A. J., & Sayer, A. A. (2019). Sarcopenia (vol 393, pg 2636, 2019). Lancet, 393(10191), 2590-2590.
  • Curcio, C. L., Gomez, F., & Reyes-Ortiz, C. A. (2009). Activity restriction related to fear of falling among older people in the Colombian Andes mountains: are functional or psychosocial risk factors more important?. Journal of Aging and Health, 21(3), 460-479.
  • Díaz-Villegas, G., Parodi, J. F., Merino-Taboada, A., Perez-Agüero, C., Castro-Viacava, G., & Runzer-Colmenares, F. M. (2016). Calf circumference and risk of falls among Peruvian older adults. European Geriatric Medicine, 7(6), 543-546.
  • Di Monaco, M., Vallero, F., Di Monaco, R., & Tappero, R. (2011). Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture. Archives of Gerontology and Geriatrics, 52(1), 71-74.
  • Drey, M., Sieber, C. C., Bertsch, T., Bauer, J. M., Schmidmaier, R., & FiAT intervention group (2016). Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clinical and Experimental Research, 28(5), 895–899.
  • Frisoli, A., Jr Chaves, P. H., Ingham, S. J., & Fried, L. P. (2011). Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: results from the Women's Health and Aging Study (WHAS) II. Bone, 48(4), 952–957.
  • Fletcher, G. S. (2019). Clinical epidemiology: the essentials. Lippincott Williams & Wilkins.
  • Fuller, G. F. (2000). Falls in the elderly. American Family Physician, 61(7), 2159–2174.
  • Gafner, S. C., Bastiaenen, C. H. G., Ferrari, S., Gold, G., Trombetti, A., Terrier, P., ... & Allet, L. (2020). The role of hip abductor strength in identifying older persons at risk of falls: a diagnostic accuracy study. Clinical Interventions in Aging, 15, 645-654
  • Gale, C. R., Cooper, C., & Aihie Sayer, A. (2016). Prevalence and risk factors for falls in older men and women: The English longitudinal study of ageing. Age and Ageing, 45(6), 789-794.
  • Gibson, M. J. (1987). The prevention of falls in later life: a report of the Kellogg International Work Group on the prevention of falls by the elderly. Danish Medical Bulletin, 34(4), 1-24.
  • Girgis, C. M., Mokbel, N., & DiGirolamo, D. J. (2014). Therapies for musculoskeletal disease: can we treat two birds with one stone?. Current Osteoporosis Reports, 12(2), 142-153.
  • Hassan, E. B., & Duque, G. (2017). Osteosarcopenia: a new geriatric syndrome. Australian Family Physician, 46(11), 849-853.
  • Hirschfeld, H. P., Kinsella, R., & Duque, G. (2017). Osteosarcopenia: where bone, muscle, and fat collide. Osteoporosis International, 28(10), 2781-2790.
  • Hunter, S. W., & Speechley, M. (2020). Evidence, recommendations, and current gaps in guidelines for fall prevention and treatments. In Falls and Cognition in Older Persons (pp. 263-72). Springer, Cham.
  • Huo, Y. R., Suriyaarachchi, P., Gomez, F., Curcio, C. L., Boersma, D., Gunawardene, P., ... & Duque, G. (2015). Comprehensive nutritional status in sarco-osteoporotic older fallers. The Journal of Nutrition, Health & Aging, 19(4), 474-480.
  • Jahantabi-Nejad, S., & Azad, A. (2019). Predictive accuracy of performance oriented mobility assessment for falls in older adults: A systematic review. Medical Journal of the Islamic Republic of Iran, 33(38), 1-6.
  • Köpke, S., & Meyer, G. (2006). The Tinetti test: Babylon in geriatric assessment. Zeitschrift fur Gerontologie und Geriatrie, 39(4), 288–291.
  • Lusardi, M. M., Fritz, S., Middleton, A., Allison, L., Wingood, M., Phillips, E., ... & Chui, K. K. (2017). Determining risk of falls in community dwelling older adults: a systematic review and meta-analysis using posttest probability. Journal of Geriatric Physical Therapy, 40(1), 1-36.
  • Nielsen, B. R., Abdulla, J., Andersen, H. E., Schwarz, P., & Suetta, C. (2018). Sarcopenia and osteoporosis in older people: a systematic review and meta-analysis. European Geriatric Medicine, 9(4), 419–434.
  • Öztorun, H. S., Bahşi, R., Turgut, T., Sürmeli, D. M., Coşarderelioğlu, Ç., Atmış, V., ... & Varlı, M. (2022). Attention to osteosarcopenia in older people! It may cause cognitive ımpairment, frailty, and mortality: a cross-sectional study. European Journal of Geriatrics and Gerontology, 4(1), 18-26.
  • Rao, S. S. (2005). Prevention of falls in older patients. American Family Physician, 72(1), 81-88.
  • Rosa, M. V., Perracini, M. R., & Ricci, N. A. (2019). Usefulness, assessment and normative data of the Functional Reach Test in older adults: a systematic review and meta-analysis. Archives of Gerontology and Geriatrics, 81, 149-170.
  • Salech, F., Marquez, C., Lera, L., Angel, B., Saguez, R., & Albala, C. (2021). Osteosarcopenia predicts falls, fractures, and mortality in Chilean community-dwelling older adults. Journal of the American Medical Directors Association, 22(4), 853-858.
  • Sepúlveda-Loyola, W., Phu, S., Hassan, E. B., Brennan-Olsen, S. L., Zanker, J., Vogrin, S., ... & Duque, G. (2020). The joint occurrence of osteoporosis and sarcopenia (osteosarcopenia): definitions and characteristics. Journal of the American Medical Directors Association, 21(2), 220-225.
  • Sibley, K. M., Beauchamp, M. K., Van Ooteghem, K., Straus, S. E., & Jaglal, S. B. (2015). Using the systems framework for postural control to analyze the components of balance evaluated in standardized balance measures: a scoping review. Archives of Physical Medicine and Rehabilitation, 96(1), 122-132.
  • Soares, S. R. M., Soares, A. B., & de Sá, A. A. R. (2013). Identification of risk factors for falls in the elderly. Journal of Health Science, 1, 36-47.
  • Teng, Z., Zhu, Y., Teng, Y., Long, Q., Hao, Q., Yu, X., ... & Lu, S. (2021). The analysis of osteosarcopenia as a risk factor for fractures, mortality, and falls. Osteoporosis International, 32(11), 2173-2183.
  • Zou, L., Han, J., Li, C., Yeung, A. S., Hui, S. S. C., Tsang, W. W., ... & Wang, L. (2019). Effects of Tai Chi on lower limb proprioception in adults aged over 55: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 100(6), 1102-1113.

The role of osteosarcopenia and balance in predicting fall risk in the elderly

Year 2022, Volume: 3 Issue: 2, 60 - 65, 25.08.2022

Funda Datlı Yakaryılmaz Neslihan Cansel

https://doi.org/10.29228/anatoljhr.62246

Abstract

Aim: The objective of this study was to investigate the role of balance and osteosarcopenia in the estimation of fall risk in the elderly admitted to the geriatrics outpatient clinic.
Methods: Patients admitted to the outpatient geriatric clinic were included in the study. The bone mineral density of 205 participants included in the study was evaluated by dual-energy X-ray absorptiometry (DXA), muscle mass bioimpedance analysis (BIA), Tinetti balance, and gait assessment (TBGA), balance and gait. Osteosarcopenia was defined as sarcopenia plus osteoporosis/osteopenia. Patients were divided into 4 groups according to BIA and DXA data.
Results: Osteosarcopenia was detected in 27 (13.2%) of all participants. In addition, while the number of falls was higher in the osteosarcopenia group than in the other groups, the calf circumference, ECC, and TBGA scores were significant. According to the TBGA score, the risk of falling was found to be high in one of every three patients. TBGA scores (p<0.001, OR=1.912 [1.596-2.291]) and calf circumference (p=0.013, OR=1.159 [1.032-1.301]) were found to be independent variables in the development of falls.
Conclusion: In this study, it was found that osteoporosis/osteopenia and sarcopenia were common in elderly patients, while balance, handgrip strength, calf circumference, and age were predictors of falling. Considering that with the aging global population, both sarcopenia and osteoporosis will become more common and therefore an increase in falls, our findings have shown that the parameters determined in the follow-up and treatment of elderly patients can be easily used in the early detection of fall risk.

Keywords

balance elderly fall osteosarcopenia

References

  • Bahat, G., Tufan, A., Tufan, F., Kilic, C., Akpinar, T. S., Kose, M., ... & Cruz-Jentoft, A. J. (2016). Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clinical Nutrition, 35(6), 1557-1563.
  • Balogun, S., Winzenberg, T., Wills, K., Scott, D., Callisaya, M., Cicuttini, F., ... & Aitken, D. (2019). Prospective associations of osteosarcopenia and osteodynapenia with incident fracture and mortality over 10 years in community-dwelling older adults. Archives of Gerontology and Geriatrics, 82, 67-73.
  • Bohannon, R. W. (2019). Grip strength: an indispensable biomarker for older adults. Clinical Interventions in Aging, 14, 1681-1691
  • Compston, J. E., McClung, M. R., & Leslie, W. D. (2019). Osteoporosis. Lancet, 393(10169), 364–376.
  • Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., ... & Zamboni, M. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16-31.
  • Cruz-Jentoft, A. J., & Sayer, A. A. (2019). Sarcopenia (vol 393, pg 2636, 2019). Lancet, 393(10191), 2590-2590.
  • Curcio, C. L., Gomez, F., & Reyes-Ortiz, C. A. (2009). Activity restriction related to fear of falling among older people in the Colombian Andes mountains: are functional or psychosocial risk factors more important?. Journal of Aging and Health, 21(3), 460-479.
  • Díaz-Villegas, G., Parodi, J. F., Merino-Taboada, A., Perez-Agüero, C., Castro-Viacava, G., & Runzer-Colmenares, F. M. (2016). Calf circumference and risk of falls among Peruvian older adults. European Geriatric Medicine, 7(6), 543-546.
  • Di Monaco, M., Vallero, F., Di Monaco, R., & Tappero, R. (2011). Prevalence of sarcopenia and its association with osteoporosis in 313 older women following a hip fracture. Archives of Gerontology and Geriatrics, 52(1), 71-74.
  • Drey, M., Sieber, C. C., Bertsch, T., Bauer, J. M., Schmidmaier, R., & FiAT intervention group (2016). Osteosarcopenia is more than sarcopenia and osteopenia alone. Aging Clinical and Experimental Research, 28(5), 895–899.
  • Frisoli, A., Jr Chaves, P. H., Ingham, S. J., & Fried, L. P. (2011). Severe osteopenia and osteoporosis, sarcopenia, and frailty status in community-dwelling older women: results from the Women's Health and Aging Study (WHAS) II. Bone, 48(4), 952–957.
  • Fletcher, G. S. (2019). Clinical epidemiology: the essentials. Lippincott Williams & Wilkins.
  • Fuller, G. F. (2000). Falls in the elderly. American Family Physician, 61(7), 2159–2174.
  • Gafner, S. C., Bastiaenen, C. H. G., Ferrari, S., Gold, G., Trombetti, A., Terrier, P., ... & Allet, L. (2020). The role of hip abductor strength in identifying older persons at risk of falls: a diagnostic accuracy study. Clinical Interventions in Aging, 15, 645-654
  • Gale, C. R., Cooper, C., & Aihie Sayer, A. (2016). Prevalence and risk factors for falls in older men and women: The English longitudinal study of ageing. Age and Ageing, 45(6), 789-794.
  • Gibson, M. J. (1987). The prevention of falls in later life: a report of the Kellogg International Work Group on the prevention of falls by the elderly. Danish Medical Bulletin, 34(4), 1-24.
  • Girgis, C. M., Mokbel, N., & DiGirolamo, D. J. (2014). Therapies for musculoskeletal disease: can we treat two birds with one stone?. Current Osteoporosis Reports, 12(2), 142-153.
  • Hassan, E. B., & Duque, G. (2017). Osteosarcopenia: a new geriatric syndrome. Australian Family Physician, 46(11), 849-853.
  • Hirschfeld, H. P., Kinsella, R., & Duque, G. (2017). Osteosarcopenia: where bone, muscle, and fat collide. Osteoporosis International, 28(10), 2781-2790.
  • Hunter, S. W., & Speechley, M. (2020). Evidence, recommendations, and current gaps in guidelines for fall prevention and treatments. In Falls and Cognition in Older Persons (pp. 263-72). Springer, Cham.
  • Huo, Y. R., Suriyaarachchi, P., Gomez, F., Curcio, C. L., Boersma, D., Gunawardene, P., ... & Duque, G. (2015). Comprehensive nutritional status in sarco-osteoporotic older fallers. The Journal of Nutrition, Health & Aging, 19(4), 474-480.
  • Jahantabi-Nejad, S., & Azad, A. (2019). Predictive accuracy of performance oriented mobility assessment for falls in older adults: A systematic review. Medical Journal of the Islamic Republic of Iran, 33(38), 1-6.
  • Köpke, S., & Meyer, G. (2006). The Tinetti test: Babylon in geriatric assessment. Zeitschrift fur Gerontologie und Geriatrie, 39(4), 288–291.
  • Lusardi, M. M., Fritz, S., Middleton, A., Allison, L., Wingood, M., Phillips, E., ... & Chui, K. K. (2017). Determining risk of falls in community dwelling older adults: a systematic review and meta-analysis using posttest probability. Journal of Geriatric Physical Therapy, 40(1), 1-36.
  • Nielsen, B. R., Abdulla, J., Andersen, H. E., Schwarz, P., & Suetta, C. (2018). Sarcopenia and osteoporosis in older people: a systematic review and meta-analysis. European Geriatric Medicine, 9(4), 419–434.
  • Öztorun, H. S., Bahşi, R., Turgut, T., Sürmeli, D. M., Coşarderelioğlu, Ç., Atmış, V., ... & Varlı, M. (2022). Attention to osteosarcopenia in older people! It may cause cognitive ımpairment, frailty, and mortality: a cross-sectional study. European Journal of Geriatrics and Gerontology, 4(1), 18-26.
  • Rao, S. S. (2005). Prevention of falls in older patients. American Family Physician, 72(1), 81-88.
  • Rosa, M. V., Perracini, M. R., & Ricci, N. A. (2019). Usefulness, assessment and normative data of the Functional Reach Test in older adults: a systematic review and meta-analysis. Archives of Gerontology and Geriatrics, 81, 149-170.
  • Salech, F., Marquez, C., Lera, L., Angel, B., Saguez, R., & Albala, C. (2021). Osteosarcopenia predicts falls, fractures, and mortality in Chilean community-dwelling older adults. Journal of the American Medical Directors Association, 22(4), 853-858.
  • Sepúlveda-Loyola, W., Phu, S., Hassan, E. B., Brennan-Olsen, S. L., Zanker, J., Vogrin, S., ... & Duque, G. (2020). The joint occurrence of osteoporosis and sarcopenia (osteosarcopenia): definitions and characteristics. Journal of the American Medical Directors Association, 21(2), 220-225.
  • Sibley, K. M., Beauchamp, M. K., Van Ooteghem, K., Straus, S. E., & Jaglal, S. B. (2015). Using the systems framework for postural control to analyze the components of balance evaluated in standardized balance measures: a scoping review. Archives of Physical Medicine and Rehabilitation, 96(1), 122-132.
  • Soares, S. R. M., Soares, A. B., & de Sá, A. A. R. (2013). Identification of risk factors for falls in the elderly. Journal of Health Science, 1, 36-47.
  • Teng, Z., Zhu, Y., Teng, Y., Long, Q., Hao, Q., Yu, X., ... & Lu, S. (2021). The analysis of osteosarcopenia as a risk factor for fractures, mortality, and falls. Osteoporosis International, 32(11), 2173-2183.
  • Zou, L., Han, J., Li, C., Yeung, A. S., Hui, S. S. C., Tsang, W. W., ... & Wang, L. (2019). Effects of Tai Chi on lower limb proprioception in adults aged over 55: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 100(6), 1102-1113.
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Primary Language English
Subjects Public Health (Other)
Journal Section Research Articles
Authors

Funda Datlı Yakaryılmaz 0000-0001-5633-0939

Neslihan Cansel 0000-0002-5519-205X

Publication Date August 25, 2022
Published in Issue Year 2022 Volume: 3 Issue: 2

Cite

APA Datlı Yakaryılmaz, F., & Cansel, N. (2022). The role of osteosarcopenia and balance in predicting fall risk in the elderly. Anatolian Journal of Health Research, 3(2), 60-65. https://doi.org/10.29228/anatoljhr.62246
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