The combination of locomotive syndrome and poor sleep quality is a risk factor of falls among community-dwelling middle-aged and older women: A cross-sectional study

Aim: The combination of locomotive syndrome (LS) and poor sleep quality (PSQ) has not yet been shown to result in falls, and the combination of locomotive syndrome (LS) and poor sleep quality (PSQ) has not yet been shown to affect bone conditions in old age and middle age.Methods: This cross-sectional study enrolled 2233 community-dwelling middle-aged to older Japanese women. LS and PSQ were assessed by the stand-up test, two-step test, the 25-question Geriatric Locomotive Function Scale, and the Pittsburgh Sleep Quality Index (PSQI). Participants with both LS 1-3 (any) and a PSQI score >= 6 were classified as belonging to the LS(+)/PSQ(+) group. The incidence of falls in the previous month was collected using a self-administered questionnaire. Bone conditions were evaluated using an ultrasonic bone densitometer.Results: The LS(+)/PSQ(+) group independently had a higher risk of falls after adjusting for confounding factors than the LS(-)/PSQ(-) group using multiple logistic regression analysis (odds ratio 1.92, 95% confidence interval 1.01-3.65, P < 0.05) LS(-)/PSQ(+) and LS(+)/PSQ(-) groups did not. Our study showed no relationships between LS(-)/PSQ(+) and LS(+)/PSQ(-) and the incidences of fall. The LS(+)/PSQ(+) group had lower trabecular bone density and cortical bone thickness than the LS(-)/PSQ(-) group (P < 0.05).Conclusion: The combination of LS and PSQ is an independent risk factor of falls, indicating that assessing both LS and PSQ could be useful in detecting middle-aged and older women with low bone density and thickness who fall easily at an early stage.