The role of ultrasonographically measured rectus femoris muscle on falls in community-dwelling older adults: a single-center study


European Geriatric Medicine, vol.14, no.5, pp.1065-1073, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 14 Issue: 5
  • Publication Date: 2023
  • Doi Number: 10.1007/s41999-023-00823-9
  • Journal Name: European Geriatric Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Page Numbers: pp.1065-1073
  • Keywords: Falls, Muscle ultrasonography, Older adults, Sarcopenia
  • Hacettepe University Affiliated: Yes


Background: There are many risk factors for falls and sarcopenia has emerged as an important risk factor. Measuring muscle mass is a useful method to determine sarcopenia. Our aim was to determine the difference in muscle mass between older adults with (fallers) and without history of falls (non-fallers) using ultrasonography (US). Methods: Two hundred ten geriatric patients were enrolled. Fall was defined as an event declared by the person who fell. Sarcopenia was defined by EWGSOP2 criteria. Muscle mass was assessed by muscle ultrasonography of five different muscles. Results: The mean age of the whole study group was 74.1 ± 6.3 years and 58.1% (n = 122) of the total study population was female. Among the participants, 69 patients (31.3%) had a fall history. The sarcopenia ratio was 23.2% in the fallers, and it was 13.7% in the non-fallers, the difference was statistically insignificant (p > 0.05), the measurement of rectus femoris muscle (RF) thickness and cross-sectional area (RFCSA) were significantly smaller among the fallers than non-fallers (p < 0.05). The ROC analysis revealed that RF and RFCSA could determine the history of falls [for RF area under curve (AUC): 0.606, 95% confidence interval (CI) 0.526–0.686, p = 0.010 and for RFCSA AUC: 0.621, 95% CI 0.538–0.704, p = 0.004]. RFCSA was statistically relevant with a history of falls, regardless of age, sex, multimorbidity, incontinence, nutritional status, and frailty status. Conclusion: Decreased RF and RFCSA determined by muscle US is a potentially modifiable risk factor for falls in older adults. Muscle US may be used for determining the risk of falls in older adults.