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Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study.

ABSTRACT: BACKGROUND:Sarcopenia and knee osteoarthritis (OA) are two major risk factors for falls in older adults. The coexistence of these two conditions may exacerbate the risk of falls. This cross-sectional study aimed to test the hypothesis that older adults with coexisting sarcopenia and knee OA displayed an increased risk of falls experience. METHODS:Participants recruited from an orthopedic clinic were divided into four groups according to the presence of sarcopenia and radiographic knee OA: isolated sarcopenia, isolated knee OA, sarcopenia + knee OA, and control (i.e., non-sarcopenia with non-OA) groups. We used questionnaires to assess falls experience in the prior 12 months. We performed logistic regression analyses to evaluate the relationship between the four groups and falls experience. RESULTS:Of 291 participants (age: 60-90 years, 78.7% women) included in this study, 25 (8.6%) had sarcopenia + knee OA. Participants with sarcopenia + knee OA had 4.17 times (95% confidence interval: 0.84, 20.6) higher odds of recurrent falls (≥2 falls) than controls after adjustment for age, sex, and body mass index. The increased recurrent falls experience was not clearly confirmed in participants with isolated sarcopenia and isolated knee OA. CONCLUSIONS:People with coexisting of sarcopenia and knee OA displayed increased recurrent falls experience. This study suggests a new concept, "sarcopenic knee OA", as a subgroup associated with higher risk of falls, which should be validated in future large cohort studies. TRIAL REGISTRATION:Not applicable.

SUBMITTER: Iijima H

PROVIDER: S-EPMC8672583 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesTo examine the patient outcomes of a comprehensive health education plus village health volunteer monitoring support program on older adults with knee osteoarthritis who are overweight and have type 2 diabetes.MethodsQuasi-experimental, two-group, pretest-posttest design was applied. Using random geographic cluster sampling, older adults who met the inclusion criteria were assigned to two groups, 62 in the intervention group and 71 in the control group. The intervention group received the comprehensive health education plus village health volunteer monitoring support program. The control group received only the comprehensive health education program. Study outcomes, including blood glucose level, knee pain and range of motion, body weight, physical ability (Timed Up and Go Test), fatigue, depressive symptoms, quality of sleep, and quality of life, were assessed at baseline, 3 months, and 6 months after enrollment and analyzed using descriptive statistics and multivariate analysis of variance.ResultsOne hundred and ten participants completed the study (55 participants in each group). Most patient outcomes in the two groups showed general improvement with statistical significance (P ≤ 0.001): pain decreased, physical ability improved, less depressive symptoms and fatigue, quality of life and sleep improved. The interaction effect (the group and time) demonstrated statistically significant differences between the intervention and control groups on pain, knee range of motion, and fatigue according to each time follow-up (P < 0.001).ConclusionsThe comprehensive health education plus village health volunteer monitoring support program promotes good patient outcomes in this population. The integrated health education resource and support for older adults with knee osteoarthritis and type 2 diabetes is an effective, non-surgical treatment that highlights professional nursing roles and non-professional roles-village health volunteers. Nurses should consider implementing a health education plus monitoring support program to mitigate the effects of chronic diseases and improve patients' quality of life.

Project description:Thailand has transitioned from an aging society to an aged society, which implies that the prevalence of age-related disorders will increase; however, epidemiological data specific to the prevalence of age-related degenerative musculoskeletal disorders among Thai older adults remain limited. Accordingly, the aim of this study was to investigate the prevalence of age-related musculoskeletal diseases, including osteoporosis, sarcopenia, and high falls risk among healthy community-dwelling Thai older adults. This cross-sectional nationwide study enrolled Thai adults aged ≥60 yr from 2 randomly selected provinces from each of the 6 regions of Thailand via stratified multistage sampling during March 2021 to August 2022. All enrolled participants were evaluated for BMD, skeletal muscle mass, grip strength, and gait speed. Osteoporosis was diagnosed according to the World Health Organization definition, and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Falls risk was determined using the self-rated Fall Risk Questionnaire. A total of 2991 eligible participants were recruited. The mean age of participants was 69.2 ± 6.5 yr (range: 60-107), and 63.1% were female. The prevalence of osteoporosis, sarcopenia, and high falls risk was 29.7%, 18.1%, and 38.5%, respectively. Approximately one-fifth of subjects (19.1%) had at least 2 of 3 risk factors (ie, osteoporosis, sarcopenia, and high falls risk) for sustaining a fragility fracture, and 3.4% had all 3 risk factors. In conclusion, the results of this study revealed a high and increasing prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults. Since these conditions are all major risk factors for fragility fracture, modification of Thailand's national health care policy is urgently needed to address the increasing prevalence of these conditions among healthy community-dwelling older adults living in Thailand.

Project description:BackgroundSarcopenia often accompanies osteoarthritis (OA), which is managed by total knee arthroplasty (TKA) in the late stage. Recent studies have suggested a higher risk of post-operative complications after TKA in sarcopenic OA subjects, but whether TKA can benefit them similar to non-sarcopenic subjects remains unexplored. This study aimed to examine the dynamic, mutual impact of sarcopenia and TKA in a one-year post-operative period.MethodsThis prospective cohort study was conducted between 2015 to 2018 at our hospital. Patients with end-stage OA of the knee waiting for TKA were recruited into the study. Primary outcome measures were change in muscle strength, mass and function. Secondary outcome measures were quality of life (QOL) measurements for pain, psychological and physical health.ResultsFifty-eight patients were recruited, of which 79.3% were female and 32.8% already had sarcopenia at baseline. The average age of sarcopenic subjects and non-sarcopenic subjects was comparable (67.89?±?7.07 vs. 67.92?±?6.85; p?=?0.99), but sarcopenic subjects had a lower body mass index (BMI) (25.64?±?2.64 vs. 28.57?±?4.04; p?=?0.01). There was a statistically significant improvement in walking speed (10.24?±?5.35 vs. 7.69?±?2.68, p?<?0.01) and muscle strength in both sarcopenic and non-sarcopenic patients after TKA. This was accompanied by an improvement trend in muscle mass in all subjects. There was no change in handgrip power before and after TKA and subsequent follow-up (19.31?±?5.92 vs. 18.98?±?6.37 vs. 19.36?±?7.66; p?=?0.97). QOL measured before, after and at follow-up with WOMAC (total: 42.27?±?15.98 vs. 20.65?±?15.24 vs. 16.65?±?18.13) and SF12v2 (PCS: 33.06?±?8.55 vs. 38.96?±?8.01 vs. 40.67?±?7.93) revealed progressive significant improvement (both comparisons p???0.01). Further analysis with the IPAQ also found increased engagement of high-intensity activities.ConclusionsThis study showed that sarcopenia among patients with end-stage OA of the knee is not uncommon, but both sarcopenic and non-sarcopenic OA patients achieved significant clinical and functional improvement after TKA. Further studies with a larger sample size and different ethnicities could help ascertain a beneficial role of TKA in sarcopenic OA subjects.Trial registrationRegistry: ClinicalTrials.gov , Registration number: NCT03579329 . Date of registration: 6 July 2018. Retrospectively registered.

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Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study.

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