Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis

Suey S. Y. Yeung, Esmee M. Reijnierse, Vivien K. Pham, Marijke C. Trappenburg, Wen Kwang Lim, Carel G. M. Meskers, Andrea B. Maier

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta-analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I 2 statistics. The search identified 2771 studies. Thirty-six studies (52 838 individuals, 48.8% females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non-sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty-three studies (45 926 individuals) were included in the meta-analysis. Sarcopenic individuals had a significant higher risk of falls (cross-sectional studies: OR 1.60; 95% CI 1.37–1.86, P < 0.001, I 2  = 34%; prospective studies: OR 1.89; 95% CI 1.33–2.68, P < 0.001, I 2  = 37%) and fractures (cross-sectional studies: OR 1.84; 95% CI 1.30–2.62, P = 0.001, I 2  = 91%; prospective studies: OR 1.71; 95% CI 1.44–2.03, P = 0.011, I 2  = 0%) compared with non-sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.
Original languageEnglish
JournalJournal of Cachexia, Sarcopenia and Muscle
DOIs
Publication statusPublished - 2019

Cite this

@article{0ec2c013455f49528d15b9f819e4974d,
title = "Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis",
abstract = "Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta-analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95{\%} confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I 2 statistics. The search identified 2771 studies. Thirty-six studies (52 838 individuals, 48.8{\%} females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non-sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty-three studies (45 926 individuals) were included in the meta-analysis. Sarcopenic individuals had a significant higher risk of falls (cross-sectional studies: OR 1.60; 95{\%} CI 1.37–1.86, P < 0.001, I 2  = 34{\%}; prospective studies: OR 1.89; 95{\%} CI 1.33–2.68, P < 0.001, I 2  = 37{\%}) and fractures (cross-sectional studies: OR 1.84; 95{\%} CI 1.30–2.62, P = 0.001, I 2  = 91{\%}; prospective studies: OR 1.71; 95{\%} CI 1.44–2.03, P = 0.011, I 2  = 0{\%}) compared with non-sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.",
author = "Yeung, {Suey S. Y.} and Reijnierse, {Esmee M.} and Pham, {Vivien K.} and Trappenburg, {Marijke C.} and Lim, {Wen Kwang} and Meskers, {Carel G. M.} and Maier, {Andrea B.}",
year = "2019",
doi = "10.1002/jcsm.12411",
language = "English",
journal = "Journal of Cachexia, Sarcopenia and Muscle",
issn = "2190-5991",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis

AU - Yeung, Suey S. Y.

AU - Reijnierse, Esmee M.

AU - Pham, Vivien K.

AU - Trappenburg, Marijke C.

AU - Lim, Wen Kwang

AU - Meskers, Carel G. M.

AU - Maier, Andrea B.

PY - 2019

Y1 - 2019

N2 - Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta-analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I 2 statistics. The search identified 2771 studies. Thirty-six studies (52 838 individuals, 48.8% females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non-sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty-three studies (45 926 individuals) were included in the meta-analysis. Sarcopenic individuals had a significant higher risk of falls (cross-sectional studies: OR 1.60; 95% CI 1.37–1.86, P < 0.001, I 2  = 34%; prospective studies: OR 1.89; 95% CI 1.33–2.68, P < 0.001, I 2  = 37%) and fractures (cross-sectional studies: OR 1.84; 95% CI 1.30–2.62, P = 0.001, I 2  = 91%; prospective studies: OR 1.71; 95% CI 1.44–2.03, P = 0.011, I 2  = 0%) compared with non-sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.

AB - Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta-analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I 2 statistics. The search identified 2771 studies. Thirty-six studies (52 838 individuals, 48.8% females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non-sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty-three studies (45 926 individuals) were included in the meta-analysis. Sarcopenic individuals had a significant higher risk of falls (cross-sectional studies: OR 1.60; 95% CI 1.37–1.86, P < 0.001, I 2  = 34%; prospective studies: OR 1.89; 95% CI 1.33–2.68, P < 0.001, I 2  = 37%) and fractures (cross-sectional studies: OR 1.84; 95% CI 1.30–2.62, P = 0.001, I 2  = 91%; prospective studies: OR 1.71; 95% CI 1.44–2.03, P = 0.011, I 2  = 0%) compared with non-sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064571570&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30993881

U2 - 10.1002/jcsm.12411

DO - 10.1002/jcsm.12411

M3 - Review article

JO - Journal of Cachexia, Sarcopenia and Muscle

JF - Journal of Cachexia, Sarcopenia and Muscle

SN - 2190-5991

ER -