Prevalence and Associated Factors of Sarcopenia in Singaporean Adults—The Yishun Study

Abstract

Objectives: To describe the normative values of sarcopenia among community-dwelling adults (21 years of age); compare the prevalence of sarcopenia using Asian Working Group for Sarcopenia criteria, 2014 (AWGS2014), Asian Working Group for Sarcopenia criteria, 2019 (AWGS2019), and European Working Group on Sarcopenia in Older People criteria, 2018 (EWGSOP2) guidelines; and identify factors associated with sarcopenia. Design: Participants were recruited through random sampling. Sarcopenia assessments were performed using a dual-energy x-ray absorptiometry scan (muscle mass), handgrip test (muscle strength), and usual walking test (physical performance). Questionnaires were administered to evaluate lifestyle and cognition. Setting and Participants: In total, 542 community-dwelling Singaporeans were recruited (21-90 years old, 57.9% women). Methods: We assessed anthropometry, body composition, and questionnaire-based physical and cognitive factors, and estimated sarcopenia prevalence according to the AWGS2014, AWGS2019, and EWGSOP2 recommendations, and examined associations using logistic regression. Results: According to AWGS2019, the Singapore population-adjusted sarcopenia prevalence was 13.6% (men 13.0%; women 14.2%) overall, and 32.2% (men 33.7%, women 30.9%) in those aged 60 years and above. The cutoffs derived from young adult reference group for low appendicular lean mass index were 5.28 kg/m2 for men and 3.69 kg/m2 for women (lower than AWGS recommended cut-off); for gait speed it was 0.82 m/s, (AWGS2019 recommended cut-off 1.0 m/s, AWGS2014 cut-off was 0.8 m/s); and for handgrip strength it was 27.9 kg/m2 for men and 16.7 kg/m2 for women (close to AWGS2019 recommendation). Age, sex, marital status, alcoholism, physical activity, body mass index, waist circumference, and global cognition were associated with sarcopenia (P < .05). Conclusions and Implications: This is the first study to provide reference values of muscle mass, strength, and gait speed across the adult lifespan of Singaporeans. Using AWGS2019 criteria, sarcopenia is prominent in older age (32.2% in 60 years old), but it is already nontrivial (6.9%) among young and middle-age persons. Multidomain lifestyle modifications addressing muscle strength, cognition, and nutrition over the adult lifespan are important to delay the development of sarcopenia.

Sarcopenia risk and associated factors among Chinese community-dwelling older adults living alone

“…The present study is among the few attempts to investigate the prevalence of probable sarcopenia according to the AWGS 2019 criteria. The prevalence of probable sarcopenia in the current study is consistent with that reported in a study conducted in Thailand (28.2%, N = 330) and Japan (30.3%, N = 552), but much higher than that reported in a study from Singapore (14.0%, N = 542) and in the UK Biobank study (5.3%, N = 499,046) 12 , 15 , 26 , 28 . Our findings suggest the usefulness of dynamometers for the easy detection of probable sarcopenia.…”

“…We reported that over 50% of our cohort of community-dwelling older adults living alone was at risk of sarcopenia. This proportion is much higher than that reported in a cohort study conducted in Hong Kong using the SARC-F (3.8%) and the AWGS 2014 criteria (7.3%), a survey conducted in China using the AWGS 2014 criteria (6.4–19.3%), a study conducted in Singapore using dual-energy X-ray absorptiometry according to the AWGS 2019 criteria (13.6%), and a large prospective epidemiological study (United Kingdom Biobank) using a bioimpedance analysis according to the EWGSOP2 criteria (6.4%) 9 , 11 , 12 , 26 , 27 . This difference in sarcopenia prevalence could be partially attributed to the different diagnostic tools used in the studies.…”

“…Another possible contributor to this discrepancy could be the different ethnic groups and characteristics of the study populations. The studies conducted in western China, Singapore, and the United Kingdom recruited a considerable number of young-to-middle-aged participants, so their results may be susceptible to healthy responder bias, leading to a lower estimation of the sarcopenia prevalence 9 , 12 , 26 . Our findings demonstrated that sarcopenia could be common among older adults living alone thereby suggesting an urgent need to scale-up preventive and therapeutic interventions to reduce the burden of sarcopenia in this high-risk population.…”

“…The pathophysiology of sarcopenia is multifaceted, and several factors have been investigated with respect to their role in the development of sarcopenia 9 , 12 , 13 . However, the reported associations of socio-demographic factors, health behaviours, and psychological factors with the risk of sarcopenia are inconsistent across studies due to heterogeneity in the study design, the operational definition of sarcopenia, the target population, and the factors analysed.…”

Nutritional status mediates the relationship between sarcopenia and cognitive impairment: findings from the WCHAT study

“…The prevalence of sarcopenia depends on the setting and the definition used. According to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, the prevalence of sarcopenia is approximately 14.9-32.2% in community-dwelling populations and 45.5-61.1% in clinic or hospital populations [4][5][6][7]. With aging populations, sarcopenia is likely to become a much more widespread public health concern worldwide in the future.…”