Lower Leg Power and Grip Strength Are Associated With Increased Fall Injury Risk in Older Men: The Osteoporotic Fractures in Men Study.
Level 3 - non-randomized controlled study
Prospective observational cohort study
PubMed 35662329 · doi:10.1093/gerona/glac122
What was done
In the Osteoporotic Fractures in Men (MrOS) prospective cohort study, 5,178 men (mean age 73.4 ± 5.7 years) with at least one follow-up visit were evaluated over 9 years. Baseline maximum leg power (Watts, Nottingham single leg press) and maximum grip strength (kg, handheld dynamometry) were measured and normalized to body weight (kg). Physical performance was assessed via gait speed and chair stands speed. Fall injuries were ascertained prospectively with questionnaires approximately every 3 years. Repeated-measures logistic regression models evaluated associations with fall injury risk.
What was found
Over 9 years, 40.4% of men (2,090 of 5,178) sustained at least one fall injury. Lower leg power per kg and grip strength per kg both showed significant trends across quartiles for higher fall injury risk (p < .0001). Risk increased by 19% per 1 standard deviation lower leg power per kg (95% CI: 1.12 to 1.26) and 16% per 1 standard deviation lower grip strength per kg (95% CI: 1.10 to 1.23). In models including both measures and adjusting for physical performance, associations remained independent (leg power per kg OR per SD = 1.13, 95% CI: 1.06 to 1.20; grip strength per kg OR per SD = 1.11, 95% CI: 1.05 to 1.17).
Why it matters
This study shows that both lower-limb power and upper-limb strength independently contribute to fall injury risk beyond routine functional tests like gait and chair-stand speed. While leg power testing may better stratify risk at higher functional levels, grip strength offers a practical clinical screening alternative.
Limits
The cohort included only older men with limited racial diversity (10.2% non-White), limiting generalizability to women and other populations. Fall injuries were self-reported via questionnaires at wide intervals (~3 years), introducing potential recall bias. Specific injury subtypes and severity were not detailed in the abstract.
Cited by
- supports Accelerated loss of muscle power with aging (powerpenia) is strongly associated with fall risk, bone fractures, and joint dislocations, particularly after age 60 or 65.