Evaluation of the Relationship Between Fall Risk, Muscle Strength, and Anticholinergic Burden in Geriatric Patients Presenting to the Emergency Department
Falls (Accidents) in Old AgeFallsAnticholinergicsSarcopeniaGeriatric
Study summary
Falls are common among older adults and can lead to serious injury. This study looks at whether taking many medications (polypharmacy), the anticholinergic burden of those medications (a measure of side effects that can affect memory, balance, and muscle function), and sarcopenia (age-related loss of muscle mass and strength) are related to fall risk in older adults visiting the emergency department.
Patients aged 65 and older who come to the emergency department will be invited to take part. With their consent, researchers will review the medications they are taking and calculate an anticholinergic burden score. Researchers will also measure the patients' hand grip strength and use ultrasound to measure the thickness of the quadriceps muscle in the thigh, both of which are used to assess muscle health. Information about the patients' history of falls in the past year, hospital stays, and other health conditions will also be collected.
All measurements are non-invasive, are already used in routine clinical practice, and are performed only once during the emergency department visit. No experimental treatment or medication will be given as part of this study.
The goal of this study is to understand how polypharmacy, anticholinergic burden, and sarcopenia relate to fall risk, both individually and together, so that older adults at higher risk of falling can be identified earlier and offered appropriate prevention strategies.
Eligibility
Sex
ALL
Min age
65 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Age 65 years or older
* Presenting to the emergency department
* Willing and able to provide written informed consent
Exclusion Criteria:
* Prior major upper or lower extremity surgery, prosthesis, or amputation preventing ultrasound or hand-grip strength measurement
* Acute bilateral femur or hip fracture precluding measurement
* Neuromuscular disease (e.g., ALS, myopathy)
* Terminal or palliative status with limited ability to cooperate with measurements
* Severe delirium or inability to cooperate with hand-grip testing
* ECOG Performance Status of 3 or 4
* Bedbound status and/or stroke sequelae preventing assessment
* Patients who decline to participate
Primary outcome measure(s)
Association Between Fall History and Polypharmacy Status — Baseline Fall history within the preceding 12 months will be evaluated in relation to polypharmacy status, defined as concurrent use of ≥5 medications, assessed via medication reconciliation. Measure: proportion of patients with polypharmacy (%) among fallers vs. non-fallers.
Association Between Fall History and Anticholinergic Burden — Baseline Fall history within the preceding 12 months will be evaluated in relation to polypharmacy status, defined as concurrent use of ≥5 medications, assessed via medication reconciliation. Measure: proportion of patients with polypharmacy (%) among fallers vs. non-fallers.
Association Between Fall History and Probable Sarcopenia — Baseline Fall history within the preceding 12 months will be evaluated in relation to probable sarcopenia, defined per EWGSOP2 criteria using hand-grip strength (measured by handheld dynamometer, kg) and combined quadriceps muscle thickness (measured by ultrasound, mm). Measure: proportion of patients meeting probable sarcopenia criteria (%) among fallers vs. non-fallers.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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