Impact of frailty on balance, fall risk, and kinesiophobia in sarcopenic elderly

The relationship between frailty and sarcopenia is well-known in older adults, but the factors associated with frailty were not adequately investigated. This study aimed to investigate the relationship between frailty levels and balance, fall risk, and kinesiophobia in older adults with primary sarcopenia and to compare them by sex.

This cross-sectional study included 68 (32 female, mean age 71.56 ± 5.04 years; 36 male, mean age 71.97 ± 4.86 years) older adults with primary sarcopenia. Sarcopenia was assessed based on grip strength, skeletal muscle mass, and physical performance. Frailty levels (Edmonton Frailty Scale (EFS)), dynamic and static balance (Force plate), fall risk (Denn Fall Risk Assessment Scale), and kinesiophobia (Tampa Kinesiophobia Scale (TSK)) of the individuals were assessed.

Sarcopenic females had statistically significantly higher levels of frailty, fall risk, kinesiophobia, and decreased balance stability areas than males (p < 0.05). The prevalence of frailty among older adults with sarcopenia was 51.5%, with a mean EFS score of 6.54 ± 2.51. Females had significantly higher frailty levels than males (7.53 ± 2.81 vs. 5.67 ± 1.83, p = 0.002). Fall risk was also higher in females (10.66 ± 5.83 vs. 7.17 ± 4.29, p = 0.007), as was kinesiophobia (47.59 ± 6.37 vs. 41.81 ± 5.09, p < 0.001). Frailty showed a moderate positive correlation with fall risk (r = 0.603, p < 0.001) and kinesiophobia (r = 0.510, p < 0.001), and a weak negative correlation with balance stability in the anterior direction (r=-0.249, p = 0.040) and to the right (r=-0.265, p = 0.030).

Sarcopenic females have higher levels of frailty and have a higher risk of falling and kinesiophobia than males. Sarcopenic females also have more impaired balance. Increased frailty levels in older sarcopenic adults are associated with increased fear of falling and kinesiophobia, and impaired balance. Therefore, assessment of frailty and associated factors in older adults with sarcopenia is essential in planning rehabilitation.