Abstract:

BACKGROUND: Subjective assessments, such as 25-question Geriatric Locomotive Function Scale (GLFS-25), balance function assessment, and gait test, are commonly used to screen for motor dysfunction and predict the risk of falls in the elderly. Therefore, the combination of impersonal assessment indicators and these subjective assessments can fully reflect the motor and balance functions of the elderly.
OBJECTIVE: To explore the application of GLFS-25 combined with bone mineral density test in screening for locomotive syndrome and risk of falls in the older adults.
METHODS: A total of 1 458 elderly people who resided in six communities of Heping District, Tianjin, China were enrolled by the method of zoning cluster random sampling. According to the GLFS-25 scores, the subjects were divided into locomotive syndrome group (198 cases, GLFS-25 ≥ 16) and non-locomotive syndrome group (1 260 cases, GLFS-25 < 16). The height, weight, body mass index, body fat percentage, and visceral fat area were compared between the two groups. The bone mineral density, fall frequency, knee flexibility and lower limb strength, balance function and gait parameters were also tested and compared between the two groups. The Pearson method was used to analyze the correlation between GLFS-25 score, bone mineral density and fall frequency, the frequency of sitting posture conversion, gait parameters and balance function score in 30 seconds. Receiver operating characteristic curve was used to analyze the efficacy of GLFS-25 combined with bone mineral density test in the diagnosis of locomotive syndrome and fall risk in the elderly.
RESULTS AND CONCLUSION: (1) Compared with the non-locomotive syndrome group, height, body mass index, and fat percentage were significantly higher in the locomotive syndrome group (P < 0.05), while the bone mineral density was significantly lower (t=7.467, P=0.000). (2) Compared with the locomotive syndrome group, the non-locomotive syndrome group showed significantly less fall frequency within 1 year and lower risk of falls, lower 30-second sitting/standing conversion frequency, worse self-balance feeling score (P=0.000), but longer total distance, faster step speed, and larger step size, and lower variation coefficient of the left and right strides (P < 0.05). (3) Pearson correlation analysis showed that there was no significant correlation between GLFS-25 score, bone mineral density and height, body mass index, and body fat percentage (P > 0.05). GLFS-25 score was negatively correlated with bone mineral density, self-balance feeling, total distance, average step speed, and average step length, but positively correlated with fall frequency, fall risk index, and variation coefficient of the left and right strides (P < 0.05). (4) Receiver operating characteristic curve analysis showed that the area under the curve of GLFS-25 combined with bone mineral density for prediction of locomotive syndrome and risk of falls was 0.895 and 0.903, respectively, which was significantly higher than that of GLFS-25 or bone mineral density test alone. And their sensitivity increased to 90.73% and 90.15%, respectively. Overall, the proportion of older adults with locomotive syndrome in Tianjin urban communities is relatively high. The patients with locomotive syndrome have higher GLFS-25 score, lower bone mineral density, lower knee flexibility, limb strength and balance, and a higher fall risk. GLFS-25 combined with bone mineral density test is therefore more effective in the screening of locomotive syndrome and fall risk assessment in the elderly.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Accidental Falls, Movement Disorders, Aged, Bone Density, Tissue Engineering