Research Abstract: Free Paper - Poster Presentation Only Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2023

Mortality, falls and slow walking speed are predicted by different muscle strength and physical performance measures in women and men (#128)

Jesse Zanker 1 2 , David Scott 3 4 , Dima Alajlouni 5 6 , Ben Kirk 1 2 , Stephanie Bird 1 2 3 , Danielle DeBruin 1 2 7 , Sara Vogrin 1 2 , Dana Bluic 5 6 , Thach Tran 5 6 , Peggy Cawthon 8 9 , Gustavo Duque 1 2 10 , Jacqueline R Center 5 6
  1. Department of Medicine, Western Health, Melbourne, Victoria, Australia
  2. Australian Institute for Musculoskeletal Science, AIMSS, Melbourne, Victoria, Australia
  3. Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
  4. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University , Clayton, Victoria , Australia
  5. Skeletal diseases program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
  6. Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
  7. Institute of Health and Sport (IHeS), Victoria University, Melbourne , Victoria, Australia
  8. Research Institute, California Pacific Medical Center, San Fransisco, California, USA
  9. Department of Epidemiology and Biostatistics, University of California San Francisco, San Fransisco, California, USA
  10. Department of Medicine, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada

Aims

Sarcopenia definitions include different measures of muscle strength, physical performance and body size/composition. We aimed to identify which baseline measures best predict incident mortality and falls, and prevalent slow walking speed, in older women and men.

 

Methods

Data for 899 women (mean age±standard deviation, 68.7±4.3 years) and 497 men (69.4±3.9 years) from the Dubbo Osteoporosis Epidemiology Study 2, comprising sixty variables/composite variables for muscle strength (quadriceps strength), physical performance (walking speed, timed up and go (TUG) and sit to stand (STS) tests), body size (weight, height) and body composition (lean mass, body fat) were included. Sex-stratified Classification and Regression Tree (CART) analyses calculated baseline variable importance and accuracy for predicting incident mortality and falls, and prevalent slow walking speed (<0.8m/s). 

 

Results

Over 14.5 years follow-up, 103/899 (11.5%) women and 96/497 (19.3%) men died, 345/899 (38.4%) women and 172/497 (34.6%) men had 1 or more fall(s), and 304/860 (35.3%) women and 172/461 (31.7%) had baseline slow walking speed (<0.8m/s). CART models identified age and walking speed adjusted for height as the most important predictors for mortality in women, and quadriceps strength with body size adjustments as the most important predictor for mortality in men. In both sexes, STS (with adjustments) was the most important predictor for incident falls, and TUG test was the most important predictor for prevalent slow walking speed (<0.8m/s). Body composition measures were not important predictors for any outcome.

 

Conclusions

Muscle strength and physical performance variables and cut points predict falls and mortality differently in women and men, suggesting targeted sex-specific application of selected measures may improve outcome prediction in older adults.