Physical Multimorbidity and Sarcopenia among Adults Aged ≥65 Years in Low- and Middle-Income Countries

L. Smith, J.I. Shin, G.F. López Sánchez, F. Schuch, M. Tully, Y. Barnett, L. Butler, D. Pizzol, N. Veronese, P. Soysal, K. Kostev, L. Jacob, A. Koyanagi

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Introduction: Physical multimorbidity is plausibly linked to sarcopenia. However, to date, only a few studies exist on this topic, and none have examined this association in low- and middle-income countries (LMICs). Thus, we aimed to investigate the association between multimorbidity and sarcopenia in a sample of older adults from six LMICs (China, Ghana, India, Mexico, Russia, South Africa). Methods: Cross-sectional, community-based data from the WHO Study on Global Ageing and Adult Health (SAGE) were analysed. Sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. A total of 11 physical chronic conditions were assessed and multimorbidity referred to ≥2 chronic conditions. Multivariable logistic regression analysis was conducted. Results: Data on 14,585 adults aged ≥65 years were analysed (mean age 72.6 years, SD 11.5 years; 53.7% females). Adjusted estimates showed that compared to no chronic physical conditions, ≥2 conditions are significantly associated with 1.49 (95% CI = 1.02–2.19) and 2.52 (95% CI = 1.53–4.15) times higher odds for sarcopenia and severe sarcopenia, respectively. Conclusions: In this large sample of older adults from LMICs, physical multimorbidity was significantly associated with sarcopenia and severe sarcopenia. Our study results tentatively suggest that targeting those with multimorbidity may aid in the prevention of sarcopenia, pending future longitudinal research.
Original languageEnglish
Pages (from-to)1-10
Early online date14 Dec 2022
Publication statusPublished online - 14 Dec 2022

Bibliographical note

Funding Information:
Dr. Guillermo F. López Sánchez is funded by the European Union – Next Generation EU. This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the US National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, and Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

Publisher Copyright:
© 2022 Pharmacology. All rights reserved.


  • Sarcopenia
  • Multimorbidity
  • Older adults
  • Low- and-middle income countries
  • Multi-country
  • Epidemiology
  • Low-and middle-income countries


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