The relation between sarcopenia, physical activity, and cognitive function in community-dwelling older adults in Malaysia: A cross-sectional study

• Main Author: Kee, Lee Ann
• Format: Thesis
• Language: English
• Published: 2025
• Subjects: R Medicine; RC Internal medicine
• Online Access: http://eprints.usm.my/63194/

This study examines the prevalence of sarcopenia among community-dwelling older adults in Malaysia and its association with cognitive function and physical activity levels. Community-dwelling older adults aged 60 y and above in high older persons ratio towns were recruited. Sarcopenia was assessed using the Skeletal Muscle Index (SMI), handgrip strength (HGS), and Short Physical Performance Battery (SPPB) based on the Asian Working Group for Sarcopenia (AWGS2) criteria. Participants were considered sarcopenic if they exhibited low muscle mass and strength/performance. Participants with all three low muscle mass, strength and performance criteria have severe sarcopenia while those with sufficient muscle mass but low strength or performance have possible sarcopenia. Cognitive function was assessed using the 1) Montreal Cognitive Assessment (MoCA) to screen for mild cognitive impairment, 2) Trail Making Test (TMT-A and TMT-B) to evaluate cognitive processing speed and flexibility, and 3) Digit Symbol Substitution Test (DSST) to assess information processing ability. Physical activity (PA) levels were measured using the Physical Activity Scale for the Elderly (PASE) that categorised PA levels as sedentary, light, and moderate-to-high. Statistical analyses were performed using R software version 4.3.0. From the 831 participants screened, a total of 677 older adults (average age 68.2 ± 6.0 y, 61.3% women) were classified as no sarcopenia (n=58, 8.6%), possible sarcopenia (n=576, 85%), sarcopenia (n=25, 3.7%) and severe sarcopenia (n=18, 2.7%). Results showed that a higher proportion of women, 5.8% (n=24) were sarcopenic compared to men, n=1 (0.4%). Overall, sarcopenic and severe sarcopenia men and women were shorter in stature and have smaller arm and calf circumferences compared to those with no or possible sarcopenia. Most sarcopenic men and women have normal HGS but outcomes for the 4-m gait speed was poor (<0.9 m/s). About 54% participants engaged in moderate-to-high levels of PA, but PA levels declined with increasing sarcopenia severity. Correlation analysis showed that age, gender, and nutritional status were significantly associated with sarcopenia (p<0.05), but not PA levels. Regression findings showed that age, gender, nutritional status, PA levels, and cognitive function collectively influenced sarcopenia risk (R² = 0.54). These findings indicate the need for early intervention through exercise programs, balanced nutrition, and continuous healthcare support to reduce the risk of sarcopenia and cognitive decline in older Malaysian adults. (370 words)