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. 2023 Sep 24;12(19):6156.
doi: 10.3390/jcm12196156.

Back Extensor Strength as a Potential Marker of Frailty Using Propensity Score Matching and Machine Learning

Taewook Kim  1 , Gowun Kim  2   3   4 , Hee-Won Park  2   3   4 , Eun Kyoung Kang  5 , Sora Baek  2   3   4
Affiliations

Back Extensor Strength as a Potential Marker of Frailty Using Propensity Score Matching and Machine Learning

Taewook Kim et al. J Clin Med. .

Abstract

This study assessed the potential of back extensor strength as an alternative marker of frailty. A total of 560 farmers were included. Computed tomography scans measured fat and muscle mass volumes at the mid-L4 vertebral level. Back extensor strength was measured in a seated posture. Multivariate linear regression was used to analyze the associations between back extensor strength and trunk muscle/fat compositions. The participants were divided into two groups based on back extensor strength. Propensity score matching, multivariate logistic regression, and Extreme Gradient Boosting (XGBoost) were employed to evaluate the relationship between Fried's frailty criteria and back extensor strength. Back extensor strength exhibited positive associations with abdominal muscle volume (r = 1.12) as well as back muscle volume (r = 0.89) (p < 0.05). Back extensor strength was linked to more frail status, such as reduced grip strength, walking speed, and frequent self-reported exhaustion. Multivariate logistic regression indicated that back extensor strength was associated with higher frail status (OR = 0.990), and XGBoost analysis identified back extensor strength as the most important predictor (gain = 0.502) for frailty. The prediction models using grip strength produced similar results (OR = 0.869, gain = 0.482). These findings suggested the potential of back extensor strength as an alternative frailty marker.

Keywords: frailty; machine learning; muscle strength.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for participant selection.
Figure 2
Figure 2
Descriptive figure for back extensor strength measurement.
Figure 3
Figure 3
The feature importance ranking of XGBoost for frailty using back extensor strength (upper) and grip strength (lower). XGBoost, Extreme Gradient Boosting; BMI, body mass index; Sex, female.
See this image and copyright information in PMC

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