Sri Ratna Rahayu, Natalia Desy Putriningtyas, Adiska Rani Ditya Candra, Azliyana Azizan, Alia Azmi, Siti Norashikin Mohamad Shaifuddin, Aufiena Nur Ayu Merzistya, Mustafa Daru Affandi, Zuyyinatun Muflikhah, Salsabila Kinaya Pranindita

Sarcopenia in Indonesian Community-Dwelling Elderly: The Prevalence and Influencing Factors within the Primary Care Setting

Introduction

Sarcopenia in indonesian community-dwelling elderly: the prevalence and influencing factors within the primary care setting. Study reveals high sarcopenia prevalence (44.44% overall, 50.33% severe) and risk factors (age, female, toilet type) in Indonesian elderly. Key for early detection in primary care.

Abstract

Determining the prevalence of sarcopenia and identifying associated factors can aid in early detection and treatment among community-dwelling elderly. This study aims to estimate the prevalence of sarcopenia and identify associated factors. This cross-sectional study was conducted in the elderly community within the two areas of Public Health Center, Semarang, Indonesia, through random sampling. Sarcopenia was defined based on the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Data on socio-demographics, clinical, and functional status were collected and associated factors analyzed using multivariable logistic regression. Of the 153 participants, the prevalence of severe sarcopenia was 50.33%, and overall sarcopenia prevalence was 44.44%. Elderly individuals with severe sarcopenia had a mean age of 69.45, with a higher occurrence in women (79.2%) compared to men. Age (p=0.003; APR: 1.105; 95% CI: 1.035-1.180), toilet type (p=0.002; APR: 4.194; 95% CI: 1.677-10.493), and being female (p=0.049; APR: 2.341; 95% CI: 1.003-5.460) were identified as risk factors for severe sarcopenia. The prevalence of severe sarcopenia is elevated among community-dwelling elderly. Sarcopenia was defined as low muscle mass with low handgrip strength and/or low gait speed. Routine check-ups are needed to detect sarcopenia and its risk factors in primary health care to enable early intervention for sarcopenia in the elderly.

Review

This study addresses a crucial public health issue by estimating the prevalence of sarcopenia and identifying associated factors among community-dwelling elderly in Indonesia. The use of the 2019 Asian Working Group for Sarcopenia (AWGS) criteria provides a standardized and regionally relevant approach to diagnosis, which is a significant strength. The reported high prevalence rates of both severe (50.33%) and overall (44.44%) sarcopenia are striking and underscore the urgent need for interventions in this demographic. The identification of age and female gender as associated factors aligns with existing global literature, reinforcing the study's foundational contribution to understanding sarcopenia within this specific context. The study effectively highlights the necessity of routine check-ups in primary healthcare for early detection and intervention. However, several aspects warrant further clarification and consideration. The abstract presents a puzzling contradiction regarding prevalence: "the prevalence of severe sarcopenia was 50.33%, and overall sarcopenia prevalence was 44.44%." This implies that severe sarcopenia is *more prevalent* than overall sarcopenia, which is counterintuitive if severe sarcopenia is a subset of the overall condition. This definitional inconsistency needs to be resolved for the reported prevalence figures to be clearly understood and interpreted. Furthermore, while the study identifies significant associations, the cross-sectional design inherently limits the ability to establish causal relationships, even though the term "risk factors" is used. The sample size of 153, while providing initial insights, is relatively small for a prevalence study in a community-dwelling population, potentially limiting the generalizability of the findings to the broader Indonesian elderly population. The finding that "toilet type" is a significant risk factor (APR: 4.194) is intriguing but lacks crucial contextual explanation within the abstract. Without elaboration, it is unclear whether this factor acts as a direct determinant of sarcopenia, a proxy for socioeconomic status, functional mobility, or another unmeasured confounder. Future research would benefit from a more detailed exploration of this unique association. To strengthen the evidence base, larger-scale, multi-center studies would be valuable for more robust prevalence estimates and generalizability. Additionally, longitudinal designs would be instrumental in establishing the causal pathways of the identified factors, moving beyond mere associations to inform more targeted and effective preventive strategies.

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