Association between sarcopenia and falls, fractures, hospital readmission, and all-cause mortality in older adults with endocrine disorders: a longitudinal study of aging in China.

Background: To explore whether older adults with sarcopenia are at greater risk for falls, fractures, hospital readmissions, and all-cause mortality compared to those without sarcopenia.

Methods: An elderly population discharged from June 2020 to January 2022 from the Department of Endocrinology of Sichuan Provincial People's Hospital was collected. The cohort included patients with various endocrine disorders, primarily type 2 diabetes mellitus, thyroid dysfunction (hypo- and hyperthyroidism), adrenal insufficiency, and metabolic syndrome. Clinicopathologic data were collected, and sarcopenia was diagnosed based on muscle mass, handgrip strength, and gait speed. Multivariate logistic and Cox regression analyses were performed to identify risk factors for sarcopenia and evaluate its association with adverse outcomes.

Results: Among 161 participants, 50 (31.06%) had sarcopenia. Sarcopenia significantly increased the risk of falls (adjusted HR: 2.38, 95% CI: 1.06-5.35, P = 0.036) but was not associated with hospital readmissions (adjusted HR: 0.87, 95% CI: 0.49-1.53, P = 0.630), fractures (adjusted HR: 1.01, 95% CI: 0.20-3.92, P = 0.992), or all-cause mortality (adjusted HR: 1.81, 95% CI: 0.49-6.67, P = 0.374). Impaired gait speed was a strong predictor of increased fall risk (adjusted HR: 5.00, 95%CI: 1.27 ~ 19.90, P = 0.022), suggesting that patients who failed the gait speed test were substantially more likely to experience falls, and grip strength was a better predictor of clinical prognosis (adjusted HR: 0.85, 95%CI: 0.77 ~ 0.95, P = 0.004).

Conclusion: Sarcopenia is independently associated with an increased risk of falls in elderly patients with endocrine-related diseases. Recognizing and treating sarcopenia can prevent falls and help improve clinical prognosis in older patients. However, the heterogeneity of underlying endocrine disorders may influence these associations and should be considered in clinical interpretation.