# Association Between Muscle Quality Assessed by the 5-Repetition Sit-to-Stand Test and Falls in Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

## TL;DR

This study shows that a muscle quality index based on a sit-to-stand test can help predict fall risk in older adults.

## Contribution

The study introduces a new muscle quality index using the 5R-STS test to assess fall risk in older adults.

## Key findings

- The MQI and gait speed were significant predictors of fall history in older adults.
- A cutoff value of 8.04 s/kg for MQI and 1.21 s for gait speed distinguished fallers from non-fallers.
- The MQI using the 5R-STS test shows potential as a fall risk indicator in community-dwelling older adults.

## Abstract

Background: Falls in older adults are a major barrier to healthy longevity. Recent studies suggest that muscle quality is associated with fall risk. This study aimed to determine whether a functional muscle quality index (MQI) using the 5-repetition sit-to-stand test (5R-STS) reflects fall risk in community-dwelling older adults. Methods: This cross-sectional study included 137 community-dwelling older adults (≥65 years) in Japan. Lower limb skeletal muscle mass (SMM) was measured using the BIA method, and muscle function was assessed using the 5R-STS. The MQI was calculated as “(5R-STS (s)/SMM (kg)) × 10”. Fall history was collected using a self-administered questionnaire, and binary logistic regression analysis including gait speed and physical frailty was performed. Results: Participants were divided into fallers (n = 36; age = 78.2 ± 5.6) and non-fallers (n = 101; age = 76.9 ± 5.3). Significant differences were found between the groups in gait speed (p = 0.01), TUG (p < 0.01), 5R-STS (p < 0.01), and MQI (p < 0.01). Binary logistic regression identified MQI (OR = 1.28; p < 0.01) and gait speed (OR = 0.14; p = 0.02) as explanatory variables for fall history. The results of the evaluation using the receiver operating characteristic (ROC) curve showed that the cutoff value for MQI to distinguish fall history was 8.04 s/kg, and the cutoff value for gait speed was 1.21 s. Conclusions: The MQI using the 5R-STS shows promise as an indicator of fall risk in older adults. Further longitudinal studies are needed to clarify the causal relationship.