Predicting falls with ultrasound, physical parameters or fall-risk questions among older adults: A prospective cohort study

• Published in: The American journal of emergency medicine 2024-10
• Main Authors: Liu, Shan W., Thatphet, Phraewa, Wongtangman, Hiti, McFadden, Kathleen, Vivian, Rachel, Morone, Christina C., Parente, Jason, Santangelo, Ilianna, Gray, Morgan, Shokoohi, Hamid, Al Saud, Ahad, Gullikson, Jamie, Hines, Ryan, Perkisas, Stanley
• Format: Article
• Language: English
• Subjects: Emergency department; Falls; Older adults; Point-of-care ultrasound; Sarcopenia
• ISSN: 0735-6757
• DOI: 10.1016/j.ajem.2024.10.008

Falls are a significant issue among older adults, leading to morbidity and mortality. Screening for fall risk in the ED is crucial but challenging due to time limitations and patient conditions. Sarcopenia, characterized by muscle loss, is associated with increased fall risk, and ultrasound has been proposed as a non-invasive tool to measure muscle mass in this context. This prospective cohort study enrolled 174 older adults from an urban teaching hospital's EDOU, assessing muscle mass via POCUS, grip strength, Timed Up and Go (TUG) test, and fall risk using the STEADI toolkit. The patients were followed up over six months to assess if they had fallen or not. Follow-up identified 37 participants (21 %) as patients who fell. There was no significant association between POCUS-measured muscle mass, grip strength, or TUG test performance with future falls. In contrast, STEADI questionnaire responses demonstrated significant differences between patients who fell and did not fall, suggesting its potential utility in predicting fall risk in this population. The simpler tool, the STEADI questionnaire, may offer more practicality in screening fall risk compared to complex ultrasound measurements or physical performance tests among the older in ED.