Physical activity patterns from mid- to late adulthood and risk of sarcopenia in older adults: the HUNT study

Background While cross-sectional studies suggest that physical activity (PA) is associated with a lower risk of sarcopenia, the long-term PA patterns remain poorly characterized. We aimed to examine whether PA patterns across mid- to late adulthood are associated with sarcopenia in older age. Methods We included 4702 individuals (mean age 76.4 ± 5.0 years, 53% female) from the HUNT4 (Trøndelag Health Study) 70+ cohort with PA data across three prior waves (HUNT1–3). PA was categorized as active or inactive at each time point (1984-86, 1995-97, 2006-08) according to the World Health Organization 2020 guidelines. Sarcopenia at HUNT4 (2017-19) was defined according to the European Working Group on Sarcopenia (EWGSOP2) criteria as probable (low strength) or confirmed (low strength and low muscle mass). Logistic regression analyses were used to examine associations between long-term PA patterns and sarcopenia. Results PA showed a clear inverse dose-response relationship with sarcopenia, with stronger associations for confirmed than probable sarcopenia. Compared with persistent inactivity, being active at all three time points was associated with 78% lower odds of confirmed sarcopenia at HUNT4 (OR 0.22, 95% CI: 0.08-0.66). Participants active at two and one time points had 40% (OR 0.60, 0.38-0.95) and 26% (OR 0.74, 0.55-1.00) lower odds, respectively. Associations varied by PA pattern, with lower odds observed among those becoming active (OR 0.57, 0.39–0.84) but not among those becoming inactive. Conclusion Long-term PA shows a clear dose–response relationship with sarcopenia risk in later life. While sustained activity across adulthood confers the greatest benefit, initiating PA even later in life remains associated with lower odds of sarcopenia.