Prevalence and general characteristics of dementia: a nationwide population-based study of electronic health records in Türkiye.

Background/aim: Türkiye is a country with an increasing life expectancy and an older adult population in parallel with the rest of the world. Several national small-scale studies were performed regarding the prevalence and characteristics of dementia in Türkiye, and the results of these studies differ from each other. We aimed to determine the prevalence of dementia in Türkiye to present the demographic characteristics, the frequency of use of health services, and the management of dementia. Materials and methods: Patients aged 65 years and over with a diagnosis of any type of dementia between January 1, 2019, and December 31, 2020, were retrospectively screened from the electronic health records of the Ministry of Health using ICD-10 codes. Results: In 2019, the total number of dementia cases identified in individuals aged 65 years and older was 247,727, of whom 150,529 (60.8%) were women. In 2020, the total number of dementia cases identified in this age group was 233,949, with 142,878 (61.1%) of these cases being women. The rate of patients admitted to the emergency department was 72.3% and 66.2% of all dementia patients in 2019 and 2020, respectively. In terms of the use of outpatient clinics, most patients with dementia were admitted to neurology (71.0% in 2019 and 62.4% in 2020). The geriatric medicine outpatient clinic was the least used by patients with dementia both in 2019 and 2020. Conclusion: The prevalence of patients living with dementia in Türkiye is lower than the global average. This suggests that most dementia cases are overlooked, highlighting the need to raise dementia awareness both in the community and among primary health care providers who frequently encounter older individuals. The study is significant in that it is the first to show the nationwide frequency of dementia in Türkiye.

A hand-in-hand phenomenon in older adults: Increased risk of frailty in geriatric outpatients associated with handgrip strength asymmetry and weakness.

OBJECTIVES: Handgrip strength (HGS) is accepted as a predictor of overall health status and a biomarker of aging, besides negative health outcomes and mortality. While differences in HGS between the dominant and non-dominant hands are expected, substantial discrepancies may signal impaired muscle function. This study aims to investigate whether handgrip asymmetry can serve as a reliable indicator of frailty in a diverse population of older adults. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: A total of 512 patients aged 65 years and older who were admitted to the geriatric medicine outpatient clinic of a university hospital were enrolled in the study. METHODS: The Clinical Frailty Scale (CFS) was used to assess the overall level of frailty of the study population. The highest recorded HGS values from the non-dominant and dominant hand were used to calculate the HGS ratio. Those with a HGS ratio of dominant and non-dominant hand <0.90 or >1.10 were defined as HGS asymmetry. RESULTS: Of the whole study group, 61.1% was female and the mean age was 73.2 ± 6.1 years. The ratio of the participants living with frailty was 57.6% (n = 219). The number of patients with HGS asymmetry was 264 (51.6%), and 48.4% (n = 248) of the study population had symmetric HGS. The normal and symmetric HGS was found in 40.2% of the non-frail group, whereas it was 23.7% in patients living with frailty. Furthermore, the ratio of low and asymmetric HGS was 16.3% in the non-frail group, and 35.0% in the patients living with frailty (p < 0.001). The presence of asymmetric and low HGS increased the risk of frailty three times independently of other confounding factors (OR:3.08; 95% CI:1.48-6.43; p = 0.003). CONCLUSIONS AND IMPLICATIONS: Identifying HGS asymmetry along with low HGS as potential indicators of frailty may provide clinicians with a clear and quantifiable criterion for assessing older patients.

Evaluation of waist-to-calf ratio as a diagnostic tool for sarcopenic obesity: a cross-sectional study from a geriatric outpatient clinic.

BACKGROUND: Proponents argue that a high waist-to-calf ratio (WCR) may indicate an imbalance between muscle and fat in the body, making it a potential predictor for sarcopenic obesity (SO). The WCR is a new index incorporating both measurements, providing a reliable approach for assessing the imbalance between abdominal fat and leg muscle mass. The present study aimed to examine the association of WCR with SO and reveal the predictive effect of SO in community-dwelling older adults. METHODS: The study population was composed of 234 geriatric outpatients with obesity. WCR was calculated by dividing the waist circumference (in cm) by the calf circumference (in cm). SO was defined according to the ESPEN and EASO Consensus Statement. RESULTS: The mean age was 72.7 ± 5.8 years, and 78.7% (n = 175) were female. Eighty-one patients (34.6%) were considered as sarcopenic obese. The WCR was 3.04 [Interquartile range (IQR), 2.88-3.32] in the sarcopenic obese group, and in the nonsarcopenic obese group, it was 2.82 [IQR, 2.7-3.0] (p < 0.001). Independent of age, sex, nutritional and frailty status WCR was associated with SO (OR 12.7, 95% CI 4.0-40.1 and p < 0.001). The cut-off value of WCR for SO was calculated as 2.94 with 72.8% sensitivity and 67.3% specificity (Area Under Curve: 0.72 and Positive likelihood ratio: 2.23, p < 0.001). CONCLUSIONS: WCR, a simple and accessible method, indicates promise as a possible and potential diagnostic tool for SO in community-dwelling older adults.

Role of muscle ultrasound in frailty assessment in older adults with type 2 diabetes mellitus.

BACKGROUND: Frailty is a geriatric syndrome that is characterized by increased vulnerability to intrinsic and extrinsic stressors due to decreased biologic reserves. Muscle ultrasound (US) is a valid and reliable method for assessing muscle quantity in older adults. The study aims to examine the relationship between frailty definitions and US-derived muscle parameters. METHODS: We conducted a cross-sectional study with type 2 diabetes mellitus outpatients in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment. For frailty assessment, the Fried Frailty Phenotype (FFP), the Clinical Frailty Scale (CFS), and the Edmonton Frailty Scale (EFS) were performed. Muscle US measurements included Gastrocnemius Medialis (GM) muscle thickness, GM fascicle length, GM pennation angle, Rectus Femoris (RF) muscle thickness, Rectus Femoris cross-sectional area (RFCSA), Rectus Abdominis (RA) muscle thickness, External Oblique (EO) muscle thickness, Internal Oblique (IO) muscle thickness, and Transverse Abdominis (TA) muscle thickness. RESULTS: In all, 373 participants were included in the study. The median age of participants was 72.7 ± 5.9 years, and 64.6% of them were female. According to the FFP, 18.2% of the participants were living with frailty, 56% of them were pre-frail; 57.4% of them were living with frailty according to the CFS; 25.2% of them were living with frailty, and 20.6% of them were pre-frail according to the EFS. The FFP, CFS, and EFS scores were related to muscle thickness of GM, RF, and RA, fascicle length of GM, and pennation angle of GM and RFCSA. Particularly, GM pennation angle, RF muscle thickness, and RFCSA were associated with an increased risk of frailty. Besides muscle thickness of GM, RF, and RA, fascicle length of GM, pennation angle of GM, and RFCSA were significant for predicting the presence of frailty. CONCLUSIONS: US-derived regional muscle measurements are associated with frailty definitions (in both physical, cumulative deficit, and multidimensional models) in a diabetic geriatric population.

An Atherosclerosis Indicator Hyaluronic Acid: Can Plasma Hyaluronic Acid Be Useful in Diagnosing Alzheimer's Disease?

BACKGROUND: The aim is to compare the plasma levels of hyaluronic acid (HA) which is closely related to inflam-mation and vascular changes and arterial stiffness (AS) related values in patients with Alzheimer's disease (AD), amnestic type mild cognitive impairment (aMCI), and normal cognitive functions (NCF). METHODS: Ninety participants were categorized into three groups, patients with AD, MCI, and NCF. Arterial stiffness measurement in the nephrology outpatient clinic, and storage and analysis of plasma samples in the biochemistry laboratory. RESULTS: Of the 90 patients, 32 had NCF, 32 had aMCI, and 26 had AD. Between groups, there was no difference in HA, pulse wave velocity, and augmentation index. The HA level had no statistically significant correlation with any of the other variables. CONCLUSIONS: Plasma HA levels will not be useful in the diagnosis of AD. More comprehensive studies with larger number of patients are needed.

Decreased abdominal wall muscle mass defined by muscle ultrasound is associated with malnutrition according to Global Leadership Initiative on Malnutrition criteria in renal transplant recipients: A cross-sectional study.

BACKGROUND: Changed body composition with increased fat content and decreased muscle mass is seen in renal transplantation recipients (RTRs). Increased fat mass might mask underlying muscle mass loss; measuring low body mass index and weight reduction alone may not be sensitive enough to diagnose malnutrition in RTRs. We aimed to determine the prevalence of malnutrition in stable RTRs using the Global Leadership Initiative on Malnutrition (GLIM) criteria and to assess the use of muscle ultrasonography (US) to compare the performance of various muscle US measurements in the diagnosis of reduced muscle mass. METHODS: Ninety-one patients who had renal transplantation >6 months ago were enrolled in the study. GLIM criteria were performed for all patients, but not those at risk of malnutrition. Bioelectrical impedance analysis and muscle US were performed to identify reduced muscle mass. RESULTS: The prevalence of malnutrition according to GLIM criteria was 25.3% (n = 23). All muscle US measurements were lower in the malnourished group than the well-nourished group; however, the malnourished group had substantially lower muscle thicknesses in abdominal muscles, specifically the external oblique (EO) and internal oblique (IO) muscles, than the well-nourished group (P = 0.001 and P = 0.007, respectively). There was a significant association between malnutrition and EO (odds ratio [OR] = 0.338, 95% CI = 0.163-0.699; P = 0.003) and IO (OR = 0.620, 95% CI = 0.427-0.900; P = 0.012) regardless of age and sex. CONCLUSION: One in four RTRs experience malnutrition. Muscle US could be used effectively for the diagnosis of reduced muscle mass and malnutrition in RTRs according to GLIM criteria.

A pilot study for a practical screening tool for dementia: validation of 5-minute cognitive test in a geriatric population.

BACKGROUND: The aim of this study is to validate the Turkish version of the 5-minute cognitive test (FCT) in a geriatric population. MATERIALS AND METHOD: In total, 61 participants aged ≥65 years with normal cognitive functions, mild cognitive impairment (MCI), and early stage dementia were included. The FCT was compared to the standardised Mini Mental State Examination (MMSE) and the Qmci-TR (quick mild cognitive impairment) test. RESULTS: Test reliability for the FCT was strong (Cronbach's α = 0.747). We demonstrated a strong correlation of FCT scores with MMSE and Qmci-TR scores (respectively, r = 0.730, P < 0.001, r = 0.723, P < 0.001). The fact that the scores obtained in the dementia group were significantly lower also showed that the test can be used reliably in the differentiation of MCI and early dementia (P < 0.001). CONCLUSIONS: The FCT is a brief, reliable, and valid cognitive screening test for screening dementia at early stages in a Turkish geriatric population.

Calf circumference predicts sarcopenia in maintenance hemodialysis.

BACKGROUND: Early recognition of sarcopenia in hemodialysis (HD) patients will be of great importance in preventing adverse outcomes and improving the quality of life in these patients. The main goal of this study was to evaluate the diagnostic accuracy of calf circumference (CC) measurement in detecting sarcopenia among CKD patients undergoing maintenance HD. METHODS: This cross-sectional study included 52 patients (53 ± 17 years) who were currently in a maintenance HD. Muscle strength was evaluated using handgrip strength, and smooth muscle mass index (SMI) was assessed through bioelectrical impedance analysis, and CC was measured at the widest part of the calf with the foot pressed against a hard surface. RESULTS: Out of the total patient population, sarcopenia was identified in 32.7% (n = 17). The two groups were comparable in terms of age, weight, and height, but the median body mass index of sarcopenic group was statistically lower than nonsarcopenic group (21.6 kg/m2 [18.9-24.6] vs 24.7 kg/m2 [21.4-27.3]. The sarcopenic group had a substantially smaller CC than the nonsarcopenic group (30.0 cm [26.5-32.0] vs 31.5 cm [30.3-34.8], P = 0.013; respectively). In the regression analysis, CC was found to be independently associated with post-HD SMI (P < 0.001; odds ratio, 1.938; and 95% CI, 1.020-2.856). CC was positively but weakly correlated with handgrip strength, however strong and significant correlation was found between CC and SMI (r = 0.277, P = 0.047 and r = 0.733, P < 0.001; respectively). A CC of 31 cm or less predicted confirmed sarcopenia in HD patients (area under the curve = 0.709, P = 0.006, specificity = 0.556, sensitivity = 0.765). CONCLUSIONS: Low muscle mass and potentially low muscle strength in HD patients can be accurately identified through the use of CC measurements. Specifically, a CC measurement below 31 cm has found to be a useful indicator to identify individuals on maintenance HD.

The Role of Muscle Ultrasonography to Diagnose Malnutrition and Sarcopenia in Maintenance Hemodialysis.

BACKGROUND: Sarcopenia and malnutrition are commonly seen and fundamental indicators of prognosis and are directly associated with increased mortality in maintenance hemodialysis (MHD) patients. We aimed to reveal the frequency of malnutrition and sarcopenia in patients undergoing MHD and investigate the role of muscle ultrasound (US) parameters to predict sarcopenia and malnutrition. METHODS: A total of 45 patients who have undertaken MHD for more than 6 months three times a week were evaluated for the present study. The US measurement was performed on gastrocnemius medialis, rectus femoris (RF), and abdominal muscles, including rectus abdominis, external oblique abdominalis, internal oblique abdominalis, and transversus abdominis. Nutritional status of the participants was assessed by mini-nutritional assessment short-form (MNA-SF). RESULTS: The prevalence of probable and confirmed sarcopenia was 51.1% (n = 23) and 35.6% (n = 16), respectively. The malnutrition and risk of malnutrition were observed in 31.1% of the whole study population (n = 14). All muscle US measurements were lower in the sarcopenic group; however, the difference is meaningful only for RF cross-sectional area (CSA) (P = .046). The malnourished group had substantially lower muscle thickness and CSA, except for the gastrocnemius muscle thickness. The value of RFCSA to predict sarcopenia and malnutrition was observed as 4.61 cm2, respectively (P < .05). RFCSA was independently associated with sarcopenia (odds ratio: 0.37; 95% confidence interval: 0.17-0.79; P = .011) and malnutrition (odds ratio: 0.45; 95% confidence interval: 0.23-0.87; P = .017). CONCLUSION: RFCSA may be a useful and simple predictor for predicting patients undergoing hemodialysis who are at risk of sarcopenia and malnutrition.

Lower gastrocnemius muscle stiffness, derived from elastography, is an independent factor for falls in older adults.

BACKGROUND AND AIMS: It is well known that components of sarcopenia (i.e., decreased muscle strength and mass) are related to falls in older adults. However, the possible effects of changes in muscle quality on falls have not been identified. This study aimed to evaluate the changes in muscle quality reflected by muscle stiffness derived from shear-wave elastography (SWE) and its association with falls in older adults. METHODS: A total of 101 geriatric outpatients were included in the study. Assessments of physical performance, muscle strength (handgrip strength), muscle mass (muscle ultrasonography and bioelectrical impedance analysis), and muscle stiffness of the medial head of gastrocnemius (GCM) in relaxation and passive stretching were performed. The history of falls in the previous year was questioned and recorded. RESULTS: The median (25-75 percentiles) age of participants was 73 (69-77) years, and 66.3% (n = 67) were female. According to fall history, participants were divided into non-fallers and fallers groups, and 72 (71.3%) and 29 (28.7%) participants were in each group, respectively. The median muscle stiffness of (Emean) the GCM in passive stretching was significantly lower in the fallers group (p < 0.001), and it was significantly correlated with the number of falls in the previous year (r: - 0.274, p: 0.010). In regression analyses, the Emean value of GCM in passive stretching was significantly associated with falls independent of confounders (OR: 0.944, 95% CI 0.90-0.98, p = 0.010). DISCUSSION AND CONCLUSION: This is the first study to reveal the relationship between falls and SWE-defined lower GCM stiffness independently of muscle mass and strength.

Turkish translation, cross-cultural adaptation and reliability of the Groningen Frailty Indicator.

BACKGROUND: Frailty is an important geriatric syndrome that can be seen as a way of recognizing and distinguishing the complex health conditions of older people. Due to the time limitation, short and simple instruments are most feasible in clinical practice, and several quick screening tools have been developed and validated, Groningen frailty indicator (GFI) is one of these scales. We aimed to validate and evaluate the reliability of the GFI in outpatient older adults in the Turkish population. METHODS: A total of 101 older patients were enrolled to the study. GFI was scored by a geriatrician for every patient at first admission to the geriatric outpatient clinic. Fried Physical Frailty Phenotype (FPFP) was performed as a reference test. RESULTS: The median age (IQR) was 72.0 (10.0) and 62.4% of the study population (n = 63) was female. Based on the GFI, 34 patients (33.7%) were defined as robust, and 67 patients (66.3%) were defined as living with frailty. There was a statistically significant concordance between GFI and FPFP (Cohen's kappa: 0.415 p < 0.001). GFI had excellent consistency in inter-rater reliability (Cronbach's alpha: 0.99, 95% CI 0.97-1.00) and in intra-rater reliability (Cronbach's alpha: 0.99, 95% CI 0.96-1.0). CONCLUSION: Our study showed that GFI is a valid and reliable scale in the Turkish older population.

How does hospitalization affect the frailty status of geriatric patients? Prospective study from internal medicine wards of a university hospital.

OBJECTIVES: Frailty is a dynamic process. Frailty in the baseline, discharge, and post-discharge are important in the management of patients. We aimed to see how hospitalization affects frailty and to evaluate its effects on health outcomes. METHODS: It was conducted with patients aged 65 and over who were hospitalized in the internal medicine wards of a university hospital. Frailty was evaluated by Clinical Frailty Scale within the first 24 h of hospitalization, within 24 h before discharge, and at third months after discharge. RESULTS: Ninety-six (57.8%) of patients at baseline, 79 (50.6%) at discharge, and 68 (47.9%) at 3 months were frail. According to baseline, 12 (7.7%) patients changed from frail to non-frail at discharge, while 4 (2.6%) patients became frail (p = 0.08). According to the baseline, 18 (12.5%) patients went from frail to non-frail at 3 months, while 7 (4.9%) patients turned frail (p = 0.04). In regression analysis, living with frailty at discharge and low education level increased re-hospitalization. Five or more are considered living with frailty. DISCUSSION: Hospitalization may have positive effects on frailty in older adult patients hospitalized in internal medicine wards, the main effect is seen to be more significant in the post-discharge follow-up.

Phase angle is associated with frailty in community-dwelling older adults.

OBJECTIVES: Frailty is a geriatric syndrome associated with adverse outcomes. Malnutrition and sarcopenia are conditions intertwined with frailty. Phase angle (PhA), used to evaluate nutritional status and sarcopenia, shows the cell membrane integrity and is closely related to clinical outcomes and mortality in many chronic conditions. The aim of this study was to evaluate the relationship between PhA and frailty in community-dwelling older adults. METHODS: The study included 299 older adults admitted to a geriatric outpatient clinic. A comprehensive geriatric assessment was performed on all participants. Frailty was evaluated via the Clinical Frailty Scale, ≥4 levels were accepted as living with frailty. All participants underwent bioelectrical impedance analysis, and PhA was recorded for each participant. RESULTS: The prevalence of frailty among the participants was 53%. The median PhA was lower in patients living with frailty than in those who were robust (5.10 [4.55-7.80] and 5.90 [3.90-6.90] degrees, respectively, and P = 0.014). Multivariable regression analysis showed that PhA was also associated with frailty in both sexes (odds ratio [OR], 0.920; P = 0.034 for men; OR, 0.81; P = 0.005 for women, respectively) independent of age, handgrip strength, nutritional status, body mass index, living alone, and burden of morbidities. CONCLUSION: PhA calculated with bioelectrical impedance analysis was significantly associated with frailty. Further research with large samples is needed to determine whether PhA demonstrates potential utility as a biomarker for frailty.

The role of ultrasonographically measured rectus femoris muscle on falls in community-dwelling older adults: a single-center study.

BACKGROUND: There are many risk factors for falls and sarcopenia has emerged as an important risk factor. Measuring muscle mass is a useful method to determine sarcopenia. Our aim was to determine the difference in muscle mass between older adults with (fallers) and without history of falls (non-fallers) using ultrasonography (US). METHODS: Two hundred ten geriatric patients were enrolled. Fall was defined as an event declared by the person who fell. Sarcopenia was defined by EWGSOP2 criteria. Muscle mass was assessed by muscle ultrasonography of five different muscles. RESULTS: The mean age of the whole study group was 74.1 ± 6.3 years and 58.1% (n = 122) of the total study population was female. Among the participants, 69 patients (31.3%) had a fall history. The sarcopenia ratio was 23.2% in the fallers, and it was 13.7% in the non-fallers, the difference was statistically insignificant (p > 0.05), the measurement of rectus femoris muscle (RF) thickness and cross-sectional area (RFCSA) were significantly smaller among the fallers than non-fallers (p < 0.05). The ROC analysis revealed that RF and RFCSA could determine the history of falls [for RF area under curve (AUC): 0.606, 95% confidence interval (CI) 0.526-0.686, p = 0.010 and for RFCSA AUC: 0.621, 95% CI 0.538-0.704, p = 0.004]. RFCSA was statistically relevant with a history of falls, regardless of age, sex, multimorbidity, incontinence, nutritional status, and frailty status. CONCLUSION: Decreased RF and RFCSA determined by muscle US is a potentially modifiable risk factor for falls in older adults. Muscle US may be used for determining the risk of falls in older adults.

Pan-immune inflammation value; a novel biomarker reflecting inflammation associated with frailty.

BACKGROUND: Frailty is suggested to be associated with age-related changes in the immune system, namely immunosenescence. Few studies have investigated the association of frailty with circulating immune biomarkers reflecting immunosenescence. Pan-immune inflammation value (PIV) is a new composite circulating immune biomarker to predict inflammation status. AIM: This study aimed to assess the relationship between PIV and frailty. METHODS: A total of 405 geriatric patients were enrolled in the study. All participants underwent a comprehensive geriatric assessment. The comorbidity burden was evaluated with Charlson Comorbidity Index. Frailty status was evaluated via the Clinical Frailty Scale (CFS), and patients with CFS scores ≥ 5 were defined as living with frailty. PIV was calculated using the formula: (Neutrophil × monocyte × platelet)/lymphocyte. Patients were defined as PIV-low (≤ 372) and PIV-high (> 372). RESULTS: The median age of participants was 72 (IQR = 67-78) years and; 63.0% (n = 225) were female. Patients were divided into two categories (i.e., robust and living with frailty groups), and 320 (79.0%) and 85 (21.0%) patients were in each group, respectively. Median PIV was higher in the living with frailty group (p = 0.008). In the linear and logistic regression analyses, both PIV and PIV-high (> 372) were significantly associated with frailty independently of confounders. DISCUSSION AND CONCLUSION: This is the first study revealing the relationship between PIV and frailty. PIV may be seen as a novel biomarker reflecting inflammation associated with frailty.

Changes in Place of Death of Older Adults during the COVID-19 Pandemic: A Retrospective Study from an Aging Country.

In the COVID-19 pandemic, due to the difficulties in patients' applications to health centres, changes have occurred in the places of death of older adults. It is aimed to investigate the change in the places of death of older adults in Turkey, which is one of the countries most affected by the pandemic. Patients admitted to the geriatric outpatient clinic of a university hospital from 01.01.2013 to 29.02.2020 were included. Place and date of death were recorded as hospital or out-of-hospital death. According to results, while the median age of those who died during the pandemic was higher than before (p < 0.001) and during the pandemic, the hospital mortality ratio was higher than before. During the pandemic period, the hospital mortality ratio of older adults has increased in Turkey. This situation, which has occurred despite the increasing healthcare burden, can show the importance of the measures taken and robust health infrastructure.

Changes in muscle quality identified by shear-wave elastography and association with sarcopenia.

BACKGROUND AND AIMS: This study aimed to investigate the potential role of shear-wave elastography (SWE) in evaluating muscle quality and assess its association with muscle strength and mass. METHODS: A total of 129 patients aged 18-87 years were included. Patients aged >65 years underwent comprehensive geriatric assessment. Anthropometric measurements, assessment of physical performance, muscle strength (handgrip strength [HGS]), muscle mass (B-mode muscle ultrasonography), and muscle quality (identified via SWE) were performed for all patients. RESULTS: The median (interquartile range) age of participants was 69 (59-76) years and 62% (n = 80) were female. According to HGS, patients were divided into normal and low HGS groups, and there were 85 (65.9%) and 44 (34.1%) patients in each group, respectively. The median average value of SWE measurement (Vmean ) of the rectus femoris (RF) in passive stretching was significantly lower in the low HGS group. In regression analyses, Vmean was significantly associated with HGS independently of age, sex, and body mass index. Optimal cutoff values of the Vmean value (m/s) of RF in passive stretching for predicting low HGS were ≤2.62 for male (area under the curve [AUC], 0.882; 95% CI, 0.705-0.938; P = <0.0001), and ≤2.52 for female (AUC, 0.719; 95% CI, 0.605-0.833; P = 0.002). CONCLUSION: To the best of our knowledge, this is the first study revealing SWE is a good predictor of muscle strength, and it could be a useful tool for evaluating muscle quality in clinical practice. Further randomized controlled studies are needed to confirm the presented cutoff values.