Calf circumference over time predicts falls risk in older adults

Longitudinal decreases in calf circumference are associated with greater odds of falls, as suggested in a study.

Researchers used data from the Chinese Longitudinal Healthy Longevity Survey and looked at participants at least 60 years of age who had complete calf circumference measurements at baseline (2018) and follow-up (2021).

Three-year changes in calf circumference were evaluated in absolute and relative terms. Absolute changes were categorized as no decrease, <3 cm, 3 to <5 cm, and ≥5 cm. Relative changes were categorized as no decrease, <10 percent, 10 percent to <20 percent, and ≥20 percent. The primary outcome of incident falls was self-reported.

The analysis included 7,068 participants (mean age 79.7 years, 54.3 percent female), of whom 1,671 (23.6 percent) reported a fall over a median follow-up of 3.1 years.

Each 1-cm absolute decrease in calf circumference was associated with 3.2-percent increased odds of fall (odds ratio [OR], 1.03, 95 percent confidence interval [CI], 1.02–1.05), while each 10-percent relative decrease was associated with 10.3 percent higher odds (OR, 1.10, 95 percent CI, 1.06–1.15).

An absolute decrease of ≥5 cm in calf circumference was associated with 32.5 percent increased odds of fall compared with no decrease (OR, 1.33, 95 percent CI, 1.10–1.60). Meanwhile, a relative decrease of ≥20 percent in calf circumference was associated with 48.1 percent greater odds of fall compared with no decrease (OR, 1.48, 95 percent CI, 1.20–1.84).

In light of the findings, monitoring changes in calf circumference over time may serve as a practical, low-cost measure to support fall risk assessment, according to the researchers.