Declines in the Five-repetition Chair Stand Test and Usual Gait Speed Predict Falls in an Outpatient Clinic for frailty

Taku Iwase, Shota Ishino, Yuto Nakao, Masanori Tanimoto, Hidenori Arai, KOKI KAWAMURA, Hiroyasu Akatsu, Hitoshi Kagaya
Purpose:

This study aimed to determine whether declines in physical measures predict falls within one year in older outpatients.

Methods:

This was a prospective cohort study that analyzed registry data from 819 outpatients. Excluding patients under 65 years, those who died within one year, and those who did not respond to the follow-up survey, 624 participants were included in the analysis. The endpoint was the incident of falls within one year. The factors investigated in this study were the five indices of physical function and skeletal muscle used in the Asian Working Group for Sarcopenia 2019 consensus criteria. These included the five-repetition chair stand test (5CS), usual gait speed (UGS), short physical performance battery (SPPB), handgrip strength (HGS), and skeletal muscle mass index (SMI). The cutoff values were 5CS ≥ 12s, UGS 1.0 m/s, SPPB ≤9 points, HGS 28 kg (male), 18 kg (female), and SMI 7.0 kg/m2 (male), 5.4 kg/m2 (female). The odds ratios for falls within one year were calculated using multiple logistic regression analysis.

Results:

The mean age of the participants was 78 ± 6 years (256 men, 368 women), and 154 (24.7%) had a fall within one year of their first visit to the frailty outpatient clinic. In univariate analysis, 5CS, UGS, and SPPB were associated with falls within one year. Those with 5CS ≥ 12 seconds had significantly more falls within one year compared with those with 5CS 12 seconds, even after adjustment for other relevant factors such as age, sex, comorbidities, Barthel Index, Mini-Mental State Examination, medications, and fall history in the past year, with an Odds Ratio [95% Confidence Interval] of 2.05 [1.26-3.36].

Conclusion(s):

A decline in physical function, particularly in the lower limbs, was associated with near-term fall risk. The 5CS is helpful for the fall risk assessment.

Implications:

At the frailty outpatient clinic, the 5CS helped screen patients at a high risk of falls within one year. Early referral to specialists and fall prevention measures such as exercise instruction and life environment adjustment are necessary after identifying a high-risk patient for falls.

Funding acknowledgements:
This work was supported by Research Funding for Longevity Sciences (22-24) and Japan Society for Promotion of Science KAKENHI (JP23K10472).
Keywords:
Outpatient
Falls
Sarcopenia
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Primary health care
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was approved by the National Center for Geriatric and Gerontology ethics committee.
Provide the ethics approval number:
approval no. 881-20
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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