Maturitas · 2026
Gluteal muscle density, but not size, is independently associated with fall risk in older adults with hip fractures: A cross-sectional study using opportunistic CT imaging.
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Ge Yufeng, Li Ruijiang, Tao Xiaohui, Chen Yixiao, Li Ting, Wang Ling, Yang Minghui, Wu Xinbao
Аннотация
OBJECTIVE: To determine whether different peri-hip muscle groups show differential associations with fear of falling and past-year fall history in older adults with hip fractures, and whether muscle density is more informative than cross-sectional area.
METHODS: This single-center, post hoc cross-sectional analysis was conducted within a prospective cohort of 590 patients aged ≥65 years with hip fractures. Fear of falling was evaluated using the Modified Falls Efficacy Scale, and past-year fall history was obtained by questionnaire. Muscle density and cross-sectional area were measured from computed tomography (CT) scans for the gluteus maximus muscle (G.MaxM), the gluteus medius and minimus muscles (G.MedMinM), and the upper thigh muscles (thighM). Multivariable logistic regression and subgroup analyses were performed.
RESULTS: Of the 590 patients, 214 (36.3%) reported fear of falling and 331 (56.1%) had had prior falls. All muscle measures were lower in the fear-of-falling group. After multivariable adjustment, only G.MedMinM density remained independently associated with lower odds of fear of falling (OR 0.77, 95% CI 0.60-0.98, P = 0.031). In contrast, G.MaxM density, thighM density, and all muscle area parameters were not independently associated with fear of falling after full adjustment. For past-year falls, G.MedMinM density showed a similar inverse association in partially adjusted models, but this association was attenuated after additional adjustment for hip bone mineral density (OR 0.82, 95% CI 0.65-1.03, P = 0.082). Associations were stronger in patients aged≥80 years, with visual impairment, or low physical activity.
CONCLUSION: Among the peri-hip muscle groups examined, G.MedMinM showed the strongest associations with fear of falling and past-year falls. Muscle density was more informative than muscle size, and G.MedMinM density remained independently associated with fear of falling. Opportunistic preoperative hip CT may help support perioperative risk stratification after hip fracture.
METHODS: This single-center, post hoc cross-sectional analysis was conducted within a prospective cohort of 590 patients aged ≥65 years with hip fractures. Fear of falling was evaluated using the Modified Falls Efficacy Scale, and past-year fall history was obtained by questionnaire. Muscle density and cross-sectional area were measured from computed tomography (CT) scans for the gluteus maximus muscle (G.MaxM), the gluteus medius and minimus muscles (G.MedMinM), and the upper thigh muscles (thighM). Multivariable logistic regression and subgroup analyses were performed.
RESULTS: Of the 590 patients, 214 (36.3%) reported fear of falling and 331 (56.1%) had had prior falls. All muscle measures were lower in the fear-of-falling group. After multivariable adjustment, only G.MedMinM density remained independently associated with lower odds of fear of falling (OR 0.77, 95% CI 0.60-0.98, P = 0.031). In contrast, G.MaxM density, thighM density, and all muscle area parameters were not independently associated with fear of falling after full adjustment. For past-year falls, G.MedMinM density showed a similar inverse association in partially adjusted models, but this association was attenuated after additional adjustment for hip bone mineral density (OR 0.82, 95% CI 0.65-1.03, P = 0.082). Associations were stronger in patients aged≥80 years, with visual impairment, or low physical activity.
CONCLUSION: Among the peri-hip muscle groups examined, G.MedMinM showed the strongest associations with fear of falling and past-year falls. Muscle density was more informative than muscle size, and G.MedMinM density remained independently associated with fear of falling. Opportunistic preoperative hip CT may help support perioperative risk stratification after hip fracture.