Sarcopenia prevalence and associated factors among older Chinese population: Findings from the China Health and Retirement Longitudinal Study

Abstract

Sarcopenia a recognised geriatric syndrome. This study aims to evaluate the prevalence of possible sarcopenia, sarcopenia and severe sarcopenia among older Chinese adults and to identify any associated factors for possible sarcopenia according to the updated diagnostic criteria of the Asian Working Group for Sarcopenia 2019 (AWGS 2019). We used data from the China Health and Retirement Longitudinal Study (CHARLS). The main outcome of this study was possible sarcopenia. Handgrip strength was measured via a dynamometer. The muscle mass was estimated by anthropometric measures. Physical performance was measured by 5-time chair stand test and gait speed test. A multivariate logistic regression model with stepwise method was employed to identify factors associated with possible sarcopenia. A total of 6172 participants aged 60–94 years were included. The prevalence of possible sarcopenia, sarcopenia and severe sarcopenia was 38.5%, 18.6%, and 8.0%, respectively. Age, rural area, falls, higher C-reactive protein (CRP), and chronic diseases (including hypertension, chronic lung diseases, heart disease, psychiatric disease and arthritis) were associated with a higher risk of possible sarcopenia. Conversely, alcohol consumption, higher gait speed and high levels of hemoglobin were associated with decreased risk of possible sarcopenia. However, the associations between possible sarcopenia with alcohol consumption, heart disease, psychiatric disease and hemoglobin were not significant after Bonferroni correction. Our study reported a relatively high prevalence of sarcopenia among older Chinese population, and identified a range of factors associated with sarcopenia. We also found rural elders are more vulnerable to sarcopenia than urban elders. Additionally, we discovered systemic inflammation might be one of the contributing factors between sarcopenia and related comorbidities. We believe the findings of this study would help to identify individuals at high risk of sarcopenia early and therefore implement the prevention and treatment strategies to reduce the disease burden in China.

Association Between Sarcopenia and Depressive Symptoms in Chinese Older Adults: Evidence From the China Health and Retirement Longitudinal Study

“…However, a systematic review comprising of 48 studies found that the “distance walked did not influence the recorded gait speed” among older adults ( 46 ). Moreover, Wu et al ( 27 ) reported that the average gait speed among individuals with sarcopenia and without sarcopenia in CHARLS 2015 was consistent with the results of a previous Chinese study. Therefore, a 2.5-m walk might be appropriate for assessing the walking speed of Chinese older residents.…”

“…Several studies have shown that the agreement of the ASM equation model and dual X-ray absorptiometry (DXA) was strong ( 24 , 25 ). The cutoff for defining low muscle mass was based on the sex-specific lowest 20% of the height-adjusted muscle mass (ASM/Ht 2 ) among the study population ( 25 – 27 ). Finally, the ASM/Ht 2 values of <5.69 kg/m 2 in women and <6.88 kg/m 2 in men were considered as low muscle mass.…”

“…Finally, the ASM/Ht 2 values of <5.69 kg/m 2 in women and <6.88 kg/m 2 in men were considered as low muscle mass. In terms of physical performance, the gait speed and the chair stand test were evaluated using the method described by Wu et al ( 27 ). Using the cutoff points from the AWGS 2019 consensus, low physical performance was defined as a five-time chair stand test ≥12 s, or gait speed on a 6-m walk <1.0 m/s, or Short Physical Performance Battery (SPPB) score <9 ( 5 ).…”

“…Using the cutoff points from the AWGS 2019 consensus, low physical performance was defined as a five-time chair stand test ≥12 s, or gait speed on a 6-m walk <1.0 m/s, or Short Physical Performance Battery (SPPB) score <9 ( 5 ). Further details about the definitions for sarcopenia components in the CHARLS have been previously published ( 27 ).…”

“…Health-related factors included body mass index (BMI), self-reported smoking and drinking status (yes or no), and 14 physician-diagnosed chronic conditions (hypertension, dyslipidemia, diabetes, cancer, chronic lung diseases, liver disease, heart disease, stroke, kidney disease, digestive disease, psychiatric disease, memory-related disease, arthritis or rheumatism, and asthma). BMI was divided into three categories according to the following WHO cutoff points for Chinese: underweight (BMI < 18.5 kg/m 2 ), normal weight (BMI = 18.5 to 24 kg/m 2 ), and overweight or obese (BMI ≥ 24 kg/m 2 ) ( 27 ). In addition, we also assessed the anemia status and cognitive function at baseline in 2015.…”