title: Strength, mobility and falling in women referred to a geriatric outpatient clinic.
abstract: OBJECTIVE
  Mobility impairment and falling have a multifactorial etiology in frail older people. Muscle weakness is one of the risk factors and is accessible to intervention. The aim of this study was to determine the most important contributors of mobility and indicators of fall occurrence in women referred to a geriatric outpatient clinic.
  
  
  METHODS
  Mobility was assessed using the Timed 'Get-Up-and-Go' test (TGUG) and the modified Coopertest (COOP). Falling was assessed retrospectively and isometric knee extension force was measured using fixed dynamometry. Habitual physical activity was quantified using a questionnaire for the elderly. Height, weight, medical conditions and current medication were recorded.
  
  
  RESULTS
  Isometric knee extension strength and habitual physical activity, which consisted predominantly of household work, were independent variables of performance on TGUG and COOP and together explained 57% of the variance in TGUG (r=0.75, p<0.001), and 64% of that in COOP, (r=0.80, p<0.001). Age, total number of medical conditions, and presence of cardiovascular disease were not significant in the model. Women in the lowest tertile of knee extension strength had a significantly higher probability of falling (0.75, 95% CI 0.56-0.91) compared with women in the highest tertile (0.27, 95% CI 0.14-0.50).
  
  
  CONCLUSIONS
  Knee extension strength remains a strong determinant of mobility and fall occurrence in women referred to a geriatric outpatient clinic. Performing light to moderate household work remains independently associated with functional mobility.
authors.affiliation: Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. hennie.janssen@home.nl
authors.forename: Hennie C J P
authors.initials: HC
authors.lastname: Janssen
authors.forename: Monique M
authors.initials: MM
authors.lastname: Samson
authors.forename: Ingrid B A E
authors.initials: IB
authors.lastname: Meeuwsen
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Duursma
authors.forename: Harald J J
authors.initials: HJ
authors.lastname: Verhaar
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D015992:Body Mass Index; D002183:Canes; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D007717:Knee / Q000502:physiology; D016014:Linear Models; D009068:Movement / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D009426:Netherlands / Q000208:ethnology; D010045:Outpatients; D014808:Vitamin D Deficiency / Q000175:diagnosis; D014853:Walkers; D016138:Walking / Q000502:physiology