Automated abdominal aortic calcification, muscle health, and incident falls: the UK Biobank Imaging Study

Emerging evidence suggests that vascular disease is linked with poorer muscle strength and higher falls risk. We evaluated the association between abdominal aortic calcification (AAC), scored using a well-established and validated 24-point machine learning algorithm (ML-AAC24), with magnetic resonance imaging-derived fat-free muscle volume (FFMV, n=33,640) and muscle fat infiltration (MFI, n=33,640), appendicular lean mass (ALM, n=36,526), handgrip strength (HGS, n=49,049), sarcopenia (n=35,834) and incident falls (n=48,482) in community-dwelling adults (mean age 64.6 ± 7.8 years, 50.9% women). ML-AAC24 was assessed on dual-energy X-ray absorptiometry (DXA)-derived lateral spine images and classified into established categories based on severity; low (