Prevalence of low muscle mass and associated factors in community-dwelling older adults in Singapore

Siew Ling Tey,Ngiap Chuan Tan,Dieu Thi Thu Huynh,Yatin Berde,Wai Leng Chow,Samuel Teong Huang Chew,Yen Ling Low,Geraldine Baggs,Magdalin Cheong,Choon How How

doi:10.1038/s41598-021-02274-3

Abstract

The population is rapidly aging worldwide, and there is an age-related decline in muscle mass. Therefore, it is important to examine the prevalence and associated factors of low appendicular skeletal muscle mass index (ASMI) in older adults. The objectives of this cross-sectional study were (i) to determine the prevalence of low ASMI (ASM/height2) and (ii) to identify factors associated with low ASMI. This study included 1211 community-dwelling adults aged ≥ 65 years. Low ASMI was defined as < 7.0 kg/m2 in males and < 5.7 kg/m2 in females (bioelectrical impedance analysis). Gender-specific cut-off values of calf circumference for low ASMI were determined. The prevalence of low ASMI in the overall cohort was 59.9%, i.e., 57.0% among males and 61.8% among females, with no significant difference between genders (P = 0.1068). The prevalence of low ASMI was 81.3% in individuals at risk of malnutrition compared to 20.6% in their counterparts with normal nutritional status (P < 0.0001). Participants with low ASMI were older, had lower physical activity scores, and greater likelihood of hospitalization in prior 6 months compared with normal ASMI (all P < 0.0001). Low ASMI was associated with risk of malnutrition (odds ratio: 3.58 for medium risk, odds ratio: 12.50 for high risk), older age, smoking, drinking, smaller calf circumference, and lower bone mass (all P ≤ 0.0328). Cut-off values of calf circumference for low ASMI for males was 33.4 cm and for females was 32.2 cm. In conclusion, we found that low ASMI was highly prevalent among community-dwelling older adults at risk of malnutrition. Other significant factors associated with low ASMI were age, smoking, drinking, calf circumference, and bone mass. Screening community-dwelling older adults for risk of malnutrition can prevent or delay onset of low ASMI.

Highlights

The population is rapidly aging worldwide, and there is an age-related decline in muscle mass
We further identified factors that were associated with increased risk for low appendicular skeletal muscle mass index (ASMI), i.e., age, malnutrition or its risk, smoking, alcohol consumption, low calf circumference, and low bone mass
Results of our study showed a high prevalence of low ASMI in community-dwelling older adults in Singapore, among those at risk of malnutrition

Summary

Introduction

The population is rapidly aging worldwide, and there is an age-related decline in muscle mass. It is important to examine the prevalence and associated factors of low appendicular skeletal muscle mass index (ASMI) in older adults. Low ASMI was associated with risk of malnutrition (odds ratio: 3.58 for medium risk, odds ratio: 12.50 for high risk), older age, smoking, drinking, smaller calf circumference, and lower bone mass (all P ≤ 0.0328). We found that low ASMI was highly prevalent among community-dwelling older adults at risk of malnutrition. Older adults with evidence of low muscle mass are at high risk of adverse health outcomes such as reduced mobility, impaired ability to perform activities of daily living and lower quality of life, fall-related injuries, infections, hospitalization and need for long-term c are[3,4] (Fig. 1). There is recognized heterogeneity in the literature findings on the impact of muscle mass on functional ability in older a dults[22,23]

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Results

Discussion

Conclusion