# Shrinking Calves Linked to More Falls in Older Adults

_Evidence Level: Moderate · Zhang C et al., JAMA network open, DOI 10.1001/jamanetworkopen.2026.40127_

*Longitudinal Change in Calf Circumference and Incident Falls in Older Adults.*

- **Evidence Level**: Moderate
- **Why this grade**: Researchers followed 7,068 older adults for three years; this cannot separate cause from effect, and falls were based on what people reported.
- **Facts**: Design: Prospective cohort study · Duration: 3 years
- **Publication Types**: Journal Article
- **Journal**: JAMA network open
- **Sample Size**: 7,068 older adults in China
- **Authors**: Zhang C, Shen J, Zhang Y, Huo Z, Zeng Y, Zhang J, Yao Y
- **Graded and published**: 2026-10-01
- **Last edited**: 2026-10-26
- **Topics**: Muscle Health, Sarcopenia, Healthy Aging
- **DOI**: https://doi.org/10.1001/jamanetworkopen.2026.40127
- **Free full text**: https://pmc.ncbi.nlm.nih.gov/articles/PMC13695073/
- **Original Source**: https://pubmed.ncbi.nlm.nih.gov/42912393/

## Summary

A tape measure around the calf gives a simple, rough idea of how much muscle is in the lower legs. Researchers in China found that older people whose calves got thinner over three years fell more often. The more the calves shrank, the stronger the link.

The data came from a nationwide health survey in China. A total of 7,068 people aged 60 or older, almost 80 on average, had their calves measured in 2018 and again in 2021. Over that time, 1,671 of them, nearly one in four, reported a new fall. They were compared with people whose calves stayed the same or grew. The link was clearest when the calf shrank by 20 percent or more, especially in people aged 80 or older.

The researchers accounted for age, past falls, illnesses and daily habits. Still, this is an observation, not proof of cause. A tape measure cannot tell muscle apart from fat or fluid in the leg. And because falls and shrinking calves happened in the same period, a fall may also have led to thinner calves. The authors see regular measuring as a cheap tool to help judge fall risk.

## Practical Takeaway

Older adults whose calves grew thinner over three years fell more often than those whose calf size stayed the same.

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_Canonical: https://longevity-cities.com/en/research/shrinking-calves-linked-to-more-falls-in-older-adults · Part of Longevity Cities · Updated 2026-10-26_