Risk of falls, fear of falls and their correlation with history of falls, anthropometrics and sarcopenia in community-dwelling older adults

Falls represent a significant and escalating concern among older adults. This issue is compounded by a vicious cycle wherein the risk of falls intertwines with the fear of falling. This cycle is further complicated by a variety of associated factors including history of falls and anthropometric measurements that contribute to heightened concerns among older adults. The present study is to examine the association and the predictors of risk of falls and fear of falls, including the history of falls, anthropometric measurements along with sarcopenia indices (SARC-F, SARC-Calf, muscle mass, muscle strength and physical performances) in older adults residing in a community-setting. This is a cross-sectional study was conducted, recruiting 315 participants aged ≥ 60 years from selected cities in Selangor, Malaysia. The risk of falls was assessed using the timed-up-and-go test, and the fear of falling was measured using the short International Fall-efficacy scale (short FES-I). Sarcopenia was screened using the SARC-F and SARC-Calf tools. The assessment of sarcopenia parameters includes muscle mass (Bioelectrical Impedance Analysis), strength (handgrip dynamometer), physical performance (5-times chair stand). The history of falls was recorded through self-administered questions. Data were analyzed using the independent t-test and chi-square for interval and categorical data, respectively. The Pearson chi-square and Binary logistic regression analysis were employed to identify relationships and influences on fall-related parameters. Result showed a history of falls is significantly associated to risk and fear of falls (p<0.05). Conversely, no anthropometric variable showed association with these falls parameters. Moving on, all sarcopenia parameters including muscle strength and physical performances showed correlation to risk and fear of falls except for muscle mass that only showed significant affect to individual with high risk of falls. After adjusting for age and gender, individual with high risk of falls had a significant (p=0.001) lower muscle mass (OR 0.627; CI 0.522-0.755), muscle strength (OR 1.069; CI: 1.034-1.105), physical performance (OR 0.787; CI: 0.895-0.986) while those with high fear of falls only had significant low physical performance (OR 1.086; CI:1.014-1.163, p=0.018) compared to those with low risk and fear of falls. In summary, the findings of present study underscore the importance of assessing sarcopenia indices when evaluating fall-related risks and fears in older adults. The results suggest that factors such as muscle strength and physical performance are closely linked to both the risk and fear of falls. Further research is needed to explore the longitudinal aspects of these associations and to inform the development of tailored preventive measures for this at-risk population.