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

​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 absorptionetry scan (muscle mass), handgrip test (muscle strenght), 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 cut-offs derived from young adult reference group for low appendicular lean mass index were 5.28 kg/m2 for mean 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.

SOURCE:
The Journal of Post-Acute and Long-Term Care Medicine

DOI:
https://doi.org/10.1016/j.jamda.2020.05.029

AUTHOR(S):
Pang BWJ, Wee SL, Lau LK, Jabber KA, Seah WT, Ng DHM, Tan QLL, Chen KK, Jagadish MU, Ng TP