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Review
. 2025 Apr 16;17(4):e82345.
doi: 10.7759/cureus.82345. eCollection 2025 Apr.

Influence of Fatty Infiltration of Muscle on Falls and Fall-Related Outcomes in Middle-Aged and Older Adults: A Systematic Review

Atsushi Shinonaga  1   2 , Hiromi Matsumoto  3 , Kensuke Tochio  2 , Shigeharu Tanaka  4 , Naoki Deguchi  5 , Ryo Tanaka  1
Affiliations
Review

Influence of Fatty Infiltration of Muscle on Falls and Fall-Related Outcomes in Middle-Aged and Older Adults: A Systematic Review

Atsushi Shinonaga et al. Cureus. .

Abstract

Fatty infiltration of muscle is increasingly recognized as a factor contributing to fall risk in middle-aged and older adults. The goal of this study is to systematically review the literature on the influence of fatty infiltration of muscle on falls and fall-related outcomes in middle-aged and older adults. Five databases - PubMed, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Igaku Chuo Zasshi - were comprehensively searched. In addition, relevant studies were identified through hand searching of the reference lists of included articles. Study quality was assessed using the Newcastle-Ottawa scale. We initially identified 1,450 articles through database searches and an additional 26 articles through hand searching. After screening, 97 observational studies were included in the final analysis. Medical imaging modalities for fatty infiltration of muscle were CT, MRI, ultrasonography, and peripheral quantitative CT. Outcomes included falls, comfortable walking speed, maximum walking speed, the timed up and go test, the short physical performance battery, muscle strength, the 6-min walk test, the five times sit-to-stand test, the 30-s chair stand test, and other balance tests. Most of the surveyed studies indicated a potential association between lower extremity major fatty infiltration of muscle and falls. Similarly, fatty infiltration of muscle was associated with poorer fall-related outcomes. However, these studies included varied participant characteristics and methods for assessing fatty infiltration of muscle and exhibited a mixed risk of bias. In conclusion, our systematic review provides important evidence on assessing fatty infiltration of the muscle for fall prevention in older adults, while underscoring the need for careful interpretation and further research, considering variations in participant characteristics, assessment methods, and potential biases.

Keywords: fall-related outcomes; falls; fatty infiltration of muscle; middle-aged; older adults.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flow diagram
PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analyses
Figure 2
Figure 2. Assessment of risk of bias in studies on falls
Figure 3
Figure 3. Assessment of risk of bias in studies on comfortable walking speed
Figure 4
Figure 4. Assessment of risk of bias in studies on maximum walking speed
Figure 5
Figure 5. Assessment of risk of bias in studies on the TUG
TUG, timed up and go test
Figure 6
Figure 6. Assessment of risk of bias in studies on the SPBB
SPBB, short physical performance battery
Figure 7
Figure 7. Assessment of risk of bias in studies on muscle strength
Figure 8
Figure 8. Assessment of risk of bias in studies on the 6MWT
6MWT, 6-min walk test
Figure 9
Figure 9. Assessment of risk of bias in studies on the 5STS
5STS, five times sit-to-stand test
Figure 10
Figure 10. Assessment of risk of bias in studies on the CS-30
CS-30, 30-s chair stand test
Figure 11
Figure 11. Assessment of risk of bias in studies on balance test or other tests
See this image and copyright information in PMC

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References

    1. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–1222. - PMC - PubMed
    1. Factors predicting fractures during falling impacts among home-dwelling older adults. Luukinen H, Koski K, Laippala P, Kivelä SL. J Am Geriatr Soc. 1997;45:1302–1309. - PubMed
    1. Prevalence and correlates of physical inactivity in community-dwelling older adults in Ireland. Murtagh EM, Murphy MH, Murphy NM, Woods C, Nevill AM, Lane A. PLoS ONE. 2015;10:0. - PMC - PubMed
    1. Falls, injuries due to falls, and the risk of admission to a nursing home. Tinetti ME, Williams CS. N Engl J Med. 1997;337:1279–1284. - PubMed
    1. Anxiety after a fall in elderly subjects and subsequent risk of developing post traumatic stress disorder at two months. A pilot study. Bloch F, Blandin M, Ranerison R, Claessens YE, Rigaud AS, Kemoun G. J Nutr Health Aging. 2014;18:303–306. - PubMed

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