Background This study aimed to determine the prevalence and risk factors for sarcopenia and severe sarcopenia among urban community-dwelling adults in Thailand, using the Asian Working Group for Sarcopenia (AWGS-2019) criteria. Methods This cross-sectional study comprising 892 older adults aged > 60 years analyzed data from a cohort study (Bangkok Falls study; 2019–2021). The appendicular skeletal muscle mass was evaluated using the Bioelectrical Impedance Analysis (BIA) method. Physical performance and muscle strength were evaluated using the five-time sit-to-stand and handgrip strength tests, respectively. Logistic regression was used to determine the factors associated with sarcopenia. Results The prevalence rates of sarcopenia and severe sarcopenia were 22.2% and 9.4%, respectively. Age ≥ 70 years (adjusted odds ratio (aOR), 2.40; 95% confidence interval (CI), 1.67–3.45), body mass index (BMI) of < 18.5 kg/m2 (aOR, 8.79; 95% CI, 4.44–17.39), Mini Nutritional Assessment (MNA) score of < 24 (aOR, 1.75; 95% CI, 1.24–2.48), and a six-item cognitive screening test score of ≥ 8 (aOR, 1.52; 95% CI, 1.08–12.15) were associated with sarcopenia. Likewise, age ≥ 70 years, BMI < 18.5 kg/m2, and an MNA score of < 24 predicted severe sarcopenia. Conclusion One-third of the urban community-dwelling older Thai adults had sarcopenia or severe sarcopenia. The age ≥ 70 years, low BMI, and inadequate nutrition increased the risk of both sarcopenia and severe sarcopenia while impaired cognitive functions predicted only sarcopenia in this population.

Purpose This study aimed to determine the validity of ultrasonographic measurement of the rectus femoris muscle (RFM) thickness as a screening tool for low appendicular muscle mass (ASM) to diagnose sarcopenia and to determine the cut-off point of RFM thickness in the Thai population. Patients and methods We enrolled 857 community-dwelling adults aged 60 years and older who were diagnosed with sarcopenia using the Asian Working Group for Sarcopenia-2019 algorithm. The RFM thickness was measured using ultrasonography and compared with bioelectrical impedance analysis (BIA) data. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated, and the area under the receiver operating curve (AUROC) was used to determine the accuracy of the test. Results A total of 857 participants were included in the study. Overall, when the cut-off values of RFM thickness of ≤1.1 cm were used for male and ≤1 cm for female, the highest sensitivity for sarcopenia diagnosis was 90.9% and specificity was 92.2%. The PPV was 76.6, and the NPV was the highest at 97.3. The highest sensitivity for the diagnosis of severe sarcopenia was 92.5% and specificity was 97.4%. The AUROC of the cut-off point of RFM thickness for the diagnosis of sarcopenia was 0.92 (95% confidence interval [CI], 0.89−0.94); for severe sarcopenia, it was 0.95 (95% CI, 0.92−0.98). Conclusion Measuring RFM thickness using ultrasonography is a feasible and reliable screening test for sarcopenia, and the cut-off values of ≤1.1 cm for male and ≤1 cm for female showed the highest accuracy for confirming low ASM in the Thai population.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, older adults experienced high mortality rates, and their deaths were often preceded by sudden health deterioration and acute respiratory failure. This prompted older adults and their families to make rapid goals-of-care decisions. Objective: This study aimed at determining the prevalence of and factors associated with COVID-19-related do-not-attempt resuscitation (DNR) decisions among older adults. Design: This was a cross-sectional population-based survey. Setting: Well-looking active (mobile) community-dwelling adults aged ≥60 years and residing in the Bangkok district, Thailand, between April and May 2020, were included in this study. We excluded older adults who (1) were unable to speak Thai, (2) had severe cognitive impairment, or (3) were blind or deaf. We interviewed participants about their perceptions regarding end-of-life decisions in case they got infected with COVID-19 and experienced respiratory arrest. Results: We recruited 848 participants with a mean age of 70.5 (±6.74) years. When asked about their choice, 49.8% chose a DNR status, 44.5% chose full life support, and 5.8% were undecided. The three most common reasons provided by the DNR group for their choice were old age (54.9%), acceptance of death (15.6%), and fear of pain (8.5%). Conclusion: Almost half of the older Thai adults chose a DNR status for scenarios in which they were infected with COVID-19 and suffered from cardiac arrest during the pandemic period. Future studies should include an in-depth examination of participants' lifestyles, family life expectancy, and religious faith to understand their end-of-life decisions.

BackgroundThe Bangkok falls study aimed to identify fall-associated factors, including home healthcare hazards, nutritional status, hydration status, sarcopenia, frailty, locomotive syndrome, and health status of urban older adults in a middle-income country.Methods This was a population-based cohort study that enrolled adults who lived in Bangkok, Thailand. Our study recruited older adults aged ≥ 60 years old, able to walk, and expected to live in the community for at least 2 years. The study had three phases included; phase 1: subject identification and terminology clarification. Phase 2: we collected data at community sites on baseline characteristic and fall risk identification. Examinations and laboratory investigations were scheduled for one month later. Phase 3: telephone follow up for falls rate, functional status and death at 3, 6, 12 months.Results A total 1,001(51.84%) people were enrolled for our study. The average age of our study was 69.9 years old (SD, 6.8), and two-thirds were female. Using “Stopping Elderly Accidents, Death and Injuries” (STEADI) screening fall risk, our study found that 37.7% had scores ≥ 4, which means that there is a risk of fall. In addition, the risk of falls increased among older adults aged 75–84 years (49.5%) and older adults aged ≥ 85 years (67.7%) (P-value < 0.001).ConclusionThis study demonstrated the feasibility of conducting a population-based cohort study among urban older adults in a middle-income country using the local community healthcare system. Our study have a tendency to provide data source for fall risk factors and disability in older adults.