Predictive ability of Achilles tendon elastography for frailty in older adults

Purpose The Achilles tendon (AT) is the largest and strongest tendon in the human body, and its elasticity is known to be affected by the aging process. However, the relation between AT stiffness and frailty in older individuals remains uncertain. This study aims to explore the potential of Achilles tendon shear wave elastography (AT-SWE) as a tool for assessing physical frailty in older adults. Methods A total of 148 patients aged 65 years and over were included in this cross-sectional study. Patients with heart failure, AT injury, stroke history, active malignancy, and claudication were excluded. All patients underwent a comprehensive geriatric assessment. Physical frailty assessment was performed with the fried frailty phenotype. Achilles tendon elastography was measured by ultrasound. Results The mean age of the participants was 73.8 years and 62.2% were female. 30.4% of the participants were defined as frail. Achilles tendon shear wave elastography measurements were statistically lower in the frail group (p < 0.05). In the multivariate regression analysis, AT-SWE demonstrated a statistically significant association with frailty independent of confounding factors (OR 0.982, 95% CI 0.965-0.999, p value = 0.038). In the ROC curve analysis, the area under the curve for AT-SWE was 0.647 (95% CI, 0.564-0.724, p < 0.01) and the optimum cut-off point was 124.1 kilopascals. Conclusion These findings highlight the value of AT-SWE as a non-invasive and objective tool for predicting frailty in older adults.