Prevalence and Risk Factors of Sarcopenia among Institutionalized Elderly in Polonnaruwa, Sri Lanka: A Pilot Cross-sectional Study

Abstract

Background: Sarcopenia, the progressive loss of muscle mass and strength, significantly reduces quality of life in older adults. Assessing its prevalence and associated risk factors in Sri Lankan elder care homes is crucial for developing effective interventions. Aims: This pilot study investigated the prevalence and associated risk factors of sarcopenia among elderly residents in care homes in Polonnaruwa, Sri Lanka. Methodology: All residents (n = 25, mean age: 73.2 ± 6.8 years) from two registered elderly care homes in Polonnaruwa were assessed. Sarcopenia was evaluated using the Asian Working Group for Sarcopenia (2019) criteria, which include handgrip strength, gait speed, and skeletal muscle mass index. Additionally, nutritional status, physical activity, depression, and dysphagia risk were assessed. Standardized anthropometric measurements were taken. Statistical analyses included t-tests, Fisher’s exact test, and logistic regression with significance at P <.05. Results: The prevalence of sarcopenia was 60%; among those, 66.7% were classified as severe. Malnutrition was a significant risk factor, as all malnourished participants (32%) were sarcopenic (P = .03). Sarcopenic individuals exhibited significantly lower gait speed (0.83 vs. 1.2 m/s, P = .03), handgrip strength (9.4 vs. 16.8 kg, P = .02), and skeletal muscle mass (4.8 vs. 6.23 kg/m², p < .004). While no significant associations were found with hypertension, diabetes, or dysphagia, depression was more prevalent among sarcopenic individuals (68.8% vs. 44.4%, P = .67). Physical inactivity showed a trend toward a higher risk of sarcopenia, with 75% of individuals in the "lower activity" category being sarcopenic compared to 33.3% in the "moderately active" group; however, this association was not statistically significant (P = .09). Conclusion: This pilot study highlights the impact of malnutrition and functional decline on sarcopenia in institutionalized elderly individuals, emphasizing the need for routine screening and targeted interventions in Sri Lankan care homes.