Prevalence of sarcopenia and possible sarcopenia and factors associated with muscle strength, muscle mass, and physical performance among institutionalized and community-dwelling older adults in Sri Lanka

Sarcopenia, characterized by progressive declines in muscle mass and strength, is an important public health concern among older adults; however, evidence from South Asia, including Sri Lanka, remains limited. This study determined the prevalence of sarcopenia and possible sarcopenia and identified factors associated with muscle strength, muscle mass, and physical performance among older Sri Lankan adults. This cross-sectional study included 200 older adults aged ≥ 65 years (100 institutionalized and 100 community-dwelling) in Kurunegala and Gampaha Districts, Sri Lanka, using convenience sampling. Sarcopenia and possible sarcopenia were classified according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Sociodemographic, anthropometric, body composition, dietary intake, physical activity, and nutritional status data were collected. Associations were examined using Spearman’s correlation, Mann-Whitney U tests, and multivariable Gamma regression with a log link adjusted for age, sex, and residential status. The prevalence of sarcopenia was 30.5% (95% CI: 24.5–37.2) and possible sarcopenia was 58.5% (95% CI: 51.6–65.1); 11.0% (95% CI: 7.4–16.1) had no sarcopenia. Sex differences were observed ( p < 0.001); possible sarcopenia was more prevalent among women (76.0%), whereas sarcopenia was more prevalent among men (57.0%). After adjustment, older age, female sex, institutional residence, lower calf circumference, and lower energy intake were associated with lower handgrip strength. Older age, institutional residence, higher waist-to-hip ratio, lower energy intake, and lower MNA score were associated with slower gait speed, while higher Body mass index (BMI), waist-to-hip ratio, calf circumference, and male sex were associated with higher appendicular skeletal muscle mass index (ASMI) (all p < 0.05). Sarcopenia and possible sarcopenia were highly prevalent in this convenience sample of institutionalized and community-dwelling older adults. Possible sarcopenia was more common among women, whereas sarcopenia was more common among men. Older age, institutional residence, and nutritional factors were associated with poorer physical function. These findings highlight the need for routine screening and nutrition-focused strategies to support muscle health among older adults. Not applicable.