Sarcopenia and Polypharmacy: A Cross-Sectional Study among Community-Dwelling Older Adults in Saudi Arabia
Keywords:
Prevalence, polypharmacy, SarcopeniaAbstract
Background and Aim: Sarcopenia, characterized by the progressive loss of muscle mass, strength, and function, is prevalent among older adults, often exacerbated by polypharmacy, defined as the concurrent use of five or more medications. This study aimed to investigate the prevalence of sarcopenia and its association with polypharmacy in community-dwelling older adults in Saudi Arabia.
Methods: A cross-sectional study was conducted with a required sample size of 245, based on a 65% prevalence rate of sarcopenia among older adults in Saudi Arabia. A total of 267 participants, attending outpatient clinics at Imam Abdulrahman bin Faisal University and King Fahad Hospital, were assessed for sarcopenia using a Jamar hydraulic handheld dynamometer to measure handgrip strength.
Results: The prevalence of sarcopenia was found to be 31.8%, significantly higher among individuals taking five or more medications (47.9%) compared to those on fewer medications (22.3%) (p < 0.001). There was no significant association between sarcopenia and falls in the previous 12 months. Patients with sarcopenia had a higher median age (69 years) than those without (64 years). Additionally, the mean body mass index (BMI) was lower in the sarcopenic group (25.9 kg/m²) compared to non-sarcopenic individuals (27.6 kg/m²) (p = 0.04). A higher prevalence of sarcopenia was noted in females (46.4%) versus males (26.2%).
Conclusion: This study highlights a strong association between polypharmacy and increased risk of sarcopenia among older adults in Saudi Arabia, emphasizing the need for careful medication management in this population.
References
Wang PY, Li Y, Wang Q. Sarcopenia: An underlying treatment target during the COVID-19 pandemic. Nutrition 2021 84:111104
Petermann-Rocha F, Balntzi V, Gray SR, Lara J, Ho FK, Pell JP, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2022 13:86-99 doi:10.1002/jcsm.12783
Shen Y, Chen J, Chen X, Hou LS, Lin X, Yang M. Prevalence and Associated Factors of Sarcopenia in Nursing Home Residents: A Systematic Review and Meta-analysis. J Am Med Dir Assoc 2019 20:5-13 doi:10.1016/j.jamda.2018.09.012
Varghese D, Ishida C, Patel P, Koya HH. Polypharmacy. Home-Based Medical Care for Older Adults: A Clinical Case Book 2024 105-10
Fick DM, Semla TP, Steinman M, Beizer J, Brandt N, Dombrowski R, et al. Polypharmacy: Evaluating Risks and Deprescribing. Am Fam Physician 2019 100:32-8
Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr 2017 17:1-10 doi:10.1186/s12877-017-0621-2
Meerkerk CDA, Chargi N, de Jong PA, van den Bos F, de Bree R. Sarcopenia measured with handgrip strength and skeletal muscle mass to assess frailty in older patients with head and neck cancer. J Geriatr Oncol 2021 12:434-40
Kim JW, Kim R, Choi H, Lee SJ, Bae GU. Understanding of sarcopenia: from definition to therapeutic strategies. Arch Pharm Res 2021 44:876-89 doi:10.1007/s12272-021-01349-z
Yoo JI, Choi H, Ha YC. Mean Hand Grip Strength and Cut-off Value for Sarcopenia in Korean Adults Using KNHANES VI. J Korean Med Sci 2017 32:868 doi:10.3346/jkms.2017.32.5.868
Lee SH, Gong HS. Measurement and Interpretation of Handgrip Strength for Research on Sarcopenia and Osteoporosis. J Bone Metab 2020 27:85 doi:10.11005/jbm.2020.27.2.85
Blanquet M, Ducher G, Sauvage A, Dadet S, Guiyedi V, Farigon N, et al. Handgrip strength as a valid practical tool to screen early-onset sarcopenia in acute care wards: a first evaluation. Eur J Clin Nutr 2021 76:56-64 doi:10.1038/s41430-021-00906-5
Prokopidis K, Giannos P, Reginster JY, Bruyere O, Petrovic M, Cherubini A, et al. Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023 14:671-83 doi:10.1002/jcsm.13190
Kuzuya M. Drug-related sarcopenia as a secondary sarcopenia. Geriatr Gerontol Int 2024 24:195-203 doi:10.1111/ggi.14770
Alodhayani AA. Sex-specific differences in the prevalence of sarcopenia among pre-frail community-dwelling older adults in Saudi Arabia. Saudi J Biol Sci 2021 28:4005-9
Sayers K, King L, Ryan S, Harty E, Donnellan C. 100 Prevalence of probable sarcopenia and associated factors in older adults undergoing Comprehensive Geriatric Assessment. Age Ageing 2023 52:S3 doi:10.1093/ageing/afad156.112
Ferreira LF, Cardoso JR, de Souza CM, Klahr P da S, da Rosa LHT. Comparison of diagnostic criteria for sarcopenia in older people: cross-sectional study. Braz J Phys Ther 2024 28:100875 doi:10.1016/j.bjpt.2024.01.001
Huang L, Liu Y, Lin T, Hou L, Song Q, Ge N, et al. Reliability and validity of two hand dynamometers when used by community-dwelling adults aged over 50 years. BMC Geriatr 2022 22:1-8 doi:10.1186/s12877-022-03270-6
Scollard TM. Handgrip Strength Assessment: A Skill to Enhance Diagnosis of Disease-related Malnutrition. Available from: www.asht.org
Diz JBM, Leopoldino AAO, Moreira B de S, Henschke N, Dias RC, Pereira LSM, et al. Prevalence of sarcopenia in older Brazilians: A systematic review and meta-analysis. Geriatr Gerontol Int 2017 17:5-16 doi:10.1111/ggi.12720
Chen Z, Li WY, Ho M, Chau PH. The prevalence of sarcopenia in Chinese older adults: Meta-analysis and meta-regression. Nutrients 2021 13:1441 doi:10.3390/nu13051441
Tanaka T, Akishita M, Kojima T, Son BK, Iijima K. Polypharmacy with potentially inappropriate medications as a risk factor of new onset sarcopenia among community-dwelling Japanese older adults: a 9-year Kashiwa cohort study. BMC Geriatr 2023 23:1-9 doi:10.1186/s12877-023-04012-y
Prokopidis K, Giannos P, Reginster JY, Bruyere O, Petrovic M, Cherubini A, et al. Sarcopenia is associated with a greater risk of polypharmacy and number of medications: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2023 14:671-83 doi:10.1002/jcsm.13190
Kuzuya M. Drug-related sarcopenia as a secondary sarcopenia. Geriatr Gerontol Int 2024 24:195-203 doi:10.1111/ggi.14770
Curtis M, Swan L, Fox R, Warters A, O’Sullivan M. Associations between Body Mass Index and Probable Sarcopenia in Community-Dwelling Older Adults. Nutrients 2023 15:1-9 doi:10.3390/nu15061850
Lau EMC, Lynn HSH, Woo JW, Kwok TCY, Melton LJ. Prevalence of and risk factors for sarcopenia in elderly Chinese men and women. J Gerontol A Biol Sci Med Sci 2005 60:213-6 doi:10.1093/gerona/60.2.213
Sung MJ, Park JY, Lee HW, Kim BK, Kim DY, Ahn SH, et al. Predictors of Sarcopenia in an Obese Asian Population. Nutr Cancer 2022 74:505-14 doi:10.1080/01635581.2021.1895232
Suzuki S, Kobayashi Y, Kobayashi H, Fujikawa T, Iwamoto T, Hirawa N, et al. Lower BMI despite having abdominal obesity is a risk of sarcopenic obesity which shows high arterial stiffness in patients with lifestyle related disease. J Hypertens 2018 36:e170 doi:10.1097/HJH.0000000000001777
Barclay RD, Burd NA, Tyler C, Tillin NA, Mackenzie RW. The Role of the IGF-1 Signaling Cascade in Muscle Protein Synthesis and Anabolic Resistance in Aging Skeletal Muscle. Front Nutr 2019 6:1 doi:10.3389/fnut.2019.00094
Hong SH, Choi KM. Sarcopenic Obesity, Insulin Resistance, and Their Implications in Cardiovascular and Metabolic Consequences. Int J Mol Sci 2020 21:1-20 doi:10.3390/ijms21020303
Hwang J, Park S. Gender-Specific Risk Factors and Prevalence for Sarcopenia among Community-Dwelling Young-Old Adults. Int J Environ Res Public Health 2022 19:7232 doi:10.3390/ijerph19127232
Hwang J, Park S. Sex Differences of Sarcopenia in an Elderly Asian Population: The Prevalence and Risk Factors. Int J Environ Res Public Health 2022 19:11980 doi:10.3390/ijerph191911980
Yeung SSY, Reijnierse EM, Pham VK, Trappenburg MC, Lim WK, Meskers CGM, et al. Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2019 10:485-500 doi:10.1002/jcsm.12425
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