The relationship between FIB-4 score and Dynapenia in older adults

Abstract

Background/Objectives: We evaluated whether fibrosis-4 (FIB-4) is associated with dynapenia and functional status in adults ≥65 years, and its value as a geriatric screening tool.

Methods: In this cross-sectional study (July 2023–July 2025), 537 outpatients aged ≥65 years were evaluated. FIB-4 was calculated by the standard formula; a high-risk threshold of ≥2.0 was applied for age ≥65. Participants were compared as low- and high-FIB-4. Functional status was assessed by Basic Activities of Daily Living (ADLs), instrumental ADLs, and gait and balance tests. Dynapenia was defined as low muscle strength. Comorbidities, geriatric syndromes, and laboratory findings were recorded.

Results: The high-FIB-4 group was older (78.6 ± 6.0 vs. 75.6 ± 5.8 years), had fewer women, and had lower BMI. POMA and instrumental ADLs scores were lower in the high-FIB-4 group, while basic ADLs and TUG duration did not differ significantly. Low grip strength was more frequent with high FIB-4. In sex-stratified analyses, FIB-4 correlated positively with age and aspartate transaminase (AST), and negatively with platelet count, leukocyte count, handgrip strength, POMA, and instrumental ADLs in women. In regression analysis low grip strength was associated with high FIB-4 score, but this relationship disappeared regardless of confounding factor in older female people. Lower BMI and higher leucocyte count is a risk factor for high FIB-4 score in the dynapenia group.

Conclusions: FIB-4 reflects not only hepatic fibrosis risk but also geriatric vulnerability linked to dynapenia and functional decline in older adults. With age-adjusted cutoffs, FIB-4 may serve as a practical early-warning screen alongside nutritional and physical-performance assessments.