Sarcopenia-related traits and risk of falls in older adults: results from meta-analysis of cohort studies and Mendelian randomization analyses

Background

Observational studies examining sarcopenia-related traits and fall risk remain controversial. Herein, we conducted meta-analyses of cohort studies triangulated with Mendelian randomization (MR) analyses to examine the potential causality between sarcopenia-related traits and risk of falls in older adults.

Methods

Literature search across PubMed, Embase, and Cochrane Library was performed from inception to February 2023 to identify cohort studies examining sarcopenia-related traits (including hand strength, appendicular lean mass, and walking speed) and falls. We assessed the association between these traits and fall risk using random-effects models to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs). MR analyses were conducted using summary statistics derived from the UK Biobank consortium for sarcopenia-related traits and FinnGen consortium for falls. The inverse-variance weighted method was used as primary analysis.

Results

Our meta-analysis included 34 cohort studies. The combined analysis of sarcopenia-related traits revealed a 33% reduced fall risk with each unit increase in walking speed (OR 0.67, 95% CI 0.54–0.84) and a 2% decrease with each unit increase in hand strength (OR 0.98, 95% CI 0.97–0.99). However, appendicular lean mass had no significant effect on falls. In the MR analyses, only walking speed was causally associated with falls (OR 0.64, 95% CI 0.48–0.84). Hand strength and appendicular lean mass showed no statistically significant causal effect on falls.

Conclusion

Evidence from meta-analysis and MR suggests a strong association between walking speed and fall risk in older adults. However, the relationship between hand strength, appendicular lean mass, and falls has not yet been established.