Relationship Between Individual Quadriceps Muscle Quality and Fall Occurrences at a 1-Year Follow-Up

Area of Science:

• Gerontology
• Musculoskeletal Imaging
• Biomedical Engineering

Background:

• Computed tomography (CT) measurements of the quadriceps femoris muscle group are increasingly associated with fall risk in older adults.
• Previous research has not specifically evaluated the relationship between individual quadriceps components and subsequent falls.
• Understanding the role of specific muscle compartments is crucial for targeted fall prevention interventions.

Purpose of the Study:

• To longitudinally investigate the association between CT-derived measurements (cross-sectional area and muscle quality) of individual quadriceps femoris components and the occurrence of falls one year later.
• To determine if specific quadriceps muscle compartments are predictive of future falls.

Main Methods:

• Single-slice CT images of the mid-thigh were acquired from 246 older adults.
• The quadriceps femoris was segmented into whole muscle, rectus femoris, vastus medialis, vastus lateralis, and vastus intermedius.
• Cross-sectional area and mean CT value (muscle quality) were calculated for each compartment.
• Participants were followed for one year to record new falls, and baseline measurements were analyzed for associations with fall occurrence.

Main Results:

• Lower CT values (indicating poorer muscle quality) were observed in females who fell for the whole quadriceps femoris, vastus lateralis, and vastus intermedius.
• Binary logistic regression identified the CT value of the vastus intermedius as the sole significant predictor of falls (p < 0.01; OR, 0.92).
• A cutoff value of 49.1 Hounsfield units for vastus intermedius CT value was identified as indicative of increased fall risk.

Conclusions:

• Muscle cross-sectional area of the quadriceps components was not associated with subsequent falls.
• The muscle quality of the vastus intermedius, as assessed by CT values, demonstrated a significant association with fall occurrence.
• These findings suggest that the condition of the vastus intermedius muscle is a critical factor influencing fall risk in older adults.