Calf circumference decline linked to falls in older adults

In a prospective cohort of 7,068 community-dwelling Chinese adults aged 60 years or older, decreases in calf circumference over about three years were associated with higher odds of reported falls. The findings suggest that tracking circumference change may help inform fall-risk assessment, but do not establish causation.

Larger calf circumference declines were associated with higher fall odds.
Falls were self-reported by 23.6% of participants.
The observational study does not establish causation.
Serial measurement may support, but not determine, risk assessment.

Researchers analyzed data from the Chinese Longitudinal Healthy Longevity Survey, including adults aged 60 years or older with calf circumference measurements in 2018 and 2021. The cohort study examined absolute and percentage changes in circumference in relation to self-reported incident falls at follow-up. Analyses used inverse probability weighting to address survival bias and adjusted for sociodemographic factors, prior falls, health behaviors, functional status, and chronic diseases.

Among 7,068 participants (mean age, 79.7 years; 54.3% women), 1,671 (23.6%) reported a fall over a median 3.07 years. Each 1-cm decrease in calf circumference was associated with 3.2% higher odds of a fall (odds ratio [OR], 1.03; 95% CI, 1.02-1.05); each 10% decrease was associated with 10.3% higher odds (OR, 1.10; 95% CI, 1.06-1.15). A decrease of at least 5 cm was associated with 32.5% higher odds, and a decrease of at least 20% with 48.1% higher odds, compared with no decrease.

The findings support further evaluation of serial calf circumference as a simple measure that could contribute to fall-risk assessment. This observational association does not show that circumference loss causes falls; falls were self-reported, and the study does not establish a threshold for clinical decisions.

In practice

In community-dwelling older adults, declining calf circumference over three years was associated with higher odds of self-reported falls, including higher odds among those with larger declines. Serial calf circumference could be considered as a simple measure to support fall-risk assessment, but the study does not establish that circumference loss causes falls or that any particular decline should trigger an intervention. The findings are observational, based on self-reported falls, and do not validate a clinical decision threshold.

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Source

JAMA Network Open: Longitudinal Change in Calf Circumference and Incident Falls in Older Adults ↗

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