Investigation of the Relationship Between Sarcopenia and Balance, Fear of Falling and Fall Risk in Older Female Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Sarcopenia
- Sponsor
- Konya Beyhekim Training and Research Hospital
- Enrollment
- 166
- Locations
- 1
- Primary Endpoint
- Berg Balance Scale(BBS)
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
This study (study type: cross-sectional) aims to investigate the relationship of sarcopenia level with balance, fear of falling and risk of falling in the elderly female population. In the first stage, 166 participants were divided into two groups: sarcopenia and non-sarcopenia. Afterwards, they were categorized according to sarcopenia level (probable sarcopenia group, sarcopenia group, severe sarcopenia group, group without sarcopenia) and comparisons were made between these subgroups. Then, they were evaluated with various scales and tests (in terms of balance, fear of falling and risk of falling).
Detailed Description
The world population is experiencing an aging trend accompanied by declines in fertility and mortality rates. This aging process varies among countries and regions. The aging of societies leads to an increase in health and socioeconomic problems. Sarcopenia is just one of the problems that arise with aging. Sarcopenia is defined as a progressive syndrome associated with a general loss of muscle mass and strength, leading to a decrease in physical function, deterioration in quality of life, and even adverse outcomes such as death. Although sarcopenia is primarily defined as a syndrome associated with the elderly population, it can also be observed in non-elderly individuals with other diseases or conditions. Therefore, due to its higher prevalence in the elderly population, it can also be referred to as a geriatric syndrome. The prevalence of sarcopenia varies depending on the measurement methods used to assess muscle mass, muscle strength, and muscle performance, as well as the population studied. The frequency of sarcopenia can range from 8% to 40% in populations aged 60 and over. Muscle mass decreases linearly in both men and women after the age of 40. These losses in muscle mass continue at a rate of 8% per decade up to the age of 70 and increase to 15% in the subsequent decades. Total loss can reach up to 50% in the eighth decade. The etiology of sarcopenia is multifactorial. Aging, certain chronic diseases, immobility, sedentary lifestyle, and nutritional deficiencies can contribute to sarcopenia. While sarcopenia can sometimes be attributed to a single cause, in most cases, a single cause cannot be identified. Sarcopenia can generally be classified into two main categories: primary and secondary. Primary sarcopenia is solely associated with the aging process, while secondary sarcopenia develops due to one or more causes (such as immobility, comorbidities, nutrition). However, it may not always be possible to make a clear distinction between primary and secondary sarcopenia. Various imaging methods such as computerized tomography (CT), magnetic resonance imaging (MRI), or dual-energy X-ray absorptiometry (DEXA) can be used to determine muscle mass in the diagnosis of sarcopenia, while anthropometric measurements such as bioimpedance analysis or upper mid-arm circumference and calf circumference may also be applied. Muscle strength is generally measured using a hand dynamometer, while methods such as walking tests, sit-to-stand tests, or stair climbing tests can be used to assess muscle performance. Individuals who have results below critical values in muscle strength measurement but have normal muscle mass, muscle quality, and physical performance values are defined as probable sarcopenia. If there is also low muscle mass in addition to decreased muscle strength, this condition is classified as sarcopenia. If there is a decrease in muscle mass or quality along with decreased muscle strength and physical performance, this condition can be classified as severe sarcopenia. Balance is an expression of postural adaptation to changes in the center of gravity during rest or movement. Factors that maintain balance are the integration of vestibular, proprioceptive, and visual data within the central nervous system and coordinated muscle activity resulting from voluntary or involuntary reflex activity. Disruption of balance predisposes to falls. A fall is a condition that usually results in an unwanted change in position, without a significant intrinsic event, strong external force, or intentional movement, usually on the ground or at a lower level. It can also be defined as an uncorrectable change in position. One of the psychological consequences of falling is fear of falling. This is defined as an anxiety condition that leads to avoidance of physical activity after a fall. This condition is often accompanied by anxiety and loss of confidence. Fear of falling may decrease over time or become continuous. Previous fall events, advanced age, being female, vision problems, depressive mood, polypharmacy, and balance disorders can be among the risk factors for fear of falling. Studies have found that sarcopenia is associated with many diseases, reduces quality of life, increases dependency, affects mortality, and increases hospitalizations. However, studies investigating the relationship between balance, risk of falling, fear of falling, and sarcopenia are limited in the literature. This study aims to investigate the relationship between the level of sarcopenia and balance, fear of falling, and risk of falling in an elderly female population.
Investigators
Fatih Güreş
Principal Investigator, Doctor
Konya Beyhekim Training and Research Hospital
Eligibility Criteria
Inclusion Criteria
- •Being over 60 years old
- •Being a woman
Exclusion Criteria
- •Those under 60 years of age
- •Hand deformities
- •Advanced knee osteoarthritis
- •Advanced hand osteoarthritis
- •Advanced osteoarthritis in the waist and hip area
- •History of Carpal Tunnel Syndrome
- •Communication disorders
- •Muscle diseases
- •Root compressions
- •History of upper and lower extremity spine surgery, prostheses and previous fracture history
Outcomes
Primary Outcomes
Berg Balance Scale(BBS)
Time Frame: During the initial evaluation of the patients, their information was recorded in approximately 1 hour.
The Berg balance scale was initially developed to evaluate postural control and is now widely used in many fields. Scoring is done on a 5-point scale that evaluates whether the patient can perform the task safely and independently within a certain period of time. 0 points are given for unrealizable performances and 4 points are given for normal performances. The points given are added together to obtain the maximum score. 0-20 points indicate high fall risk, 21-40 points indicate medium fall risk, 41-56 points indicate low fall risk.
Falls Efficacy Scale (FES)
Time Frame: During the initial evaluation of the patients, their information was recorded in approximately 1 hour.
Developed based on low perceived self-efficacy, FES is a reliable and valid method to measure fear of falling. Such as taking a bath, taking a shower, reaching shelves, walking around the house, preparing meals without carrying heavy or hot objects, getting in and out of bed, answering the door or telephone ring, sitting on a chair and getting up, dressing and undressing, going to the toilet and leaving the toilet, personal care. Patients are asked to rate their daily living activities. The points given are evaluated between "1 point I trust very much" and "10 points I do not trust at all", the scores between 0 and 10 are summed and the resulting score is recorded.
Sociodemographic data
Time Frame: During the initial evaluation of the patients, their information was recorded in approximately 1 hour.
A form was created to determine the sociodemographic characteristics of the patients. In addition, data on the number of falls and fractures in the last year was also obtained in this form.
Balance and Gait Assessment Scale
Time Frame: During the initial evaluation of the patients, their information was recorded in approximately 1 hour.
This scale is an important tool to evaluate the individual's functional status and daily living activities. The scale consists of a maximum of 16 points for balance and a maximum of 12 points for walking, for a total of 28 points. Individuals who score 26 or below on the scale are thought to have a problem; For those with scores of 19 or below, it is observed that the risk of self-falling increases fivefold compared to normal individuals.
Secondary Outcomes
- Co-morbidities(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Instrumental activities of living (Lawton-Brody; IADL)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Mini-mental state assessment (MMSE)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- FRAIL fragility index(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Short physical performance battery (SPPB)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Timed up and go test (TUG)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Biochemical data(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Basic activities of daily living (Katz)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Number of drugs(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Mini-nutritional evaluation (MNA-Short form)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- Yesavage Geriatric Depression Scale Short Form (GDS-SF)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)
- The Tampa Scale for Kinesiophobia (TSK)(During the initial evaluation of the patients, their information was recorded in approximately 1 hour.)