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), AsianWorking Group for Sarcopenia criteria, 2019 (AWGS2019), and EuropeanWorking Group on Sarcopenia in Older People criteria, 2018(EWGSOP2) guidelines; and identify factors associatedwith 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 fromyoung adult reference group for lowappendicular leanmass indexwere 5.28 kg/m2 formen 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 formen and16.7 kg/m2 forwomen (close to AWGS2019 recommendation).Age, sex,marital status, alcoholism, physical activity, bodymass index,waist circumference, and global cognitionwere 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.