Sleep duration and sarcopenia in adults aged ≥ 65 years from low and middle-income countries

Lee Smith, Jae Il Shin, Nicola Veronese, Pinar Soysal, Guillermo F López Sánchez, Damiano Pizzol, Jacopo Demurtas, Mark A Tully, Yvonne Barnett, Laurie Butler, Ai Koyanagi

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BACKGROUND: Sleep duration may influence risk for sarcopenia but studies on this topic are scarce, especially from low and- middle-income countries (LMICs). Thus, the aim of the present study was to investigate the association between sleep duration and sarcopenia among adults aged ≥ 65 years from five LMICs (China, Ghana, India, 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. Self-reported sleep duration in the past two nights were averaged and classified as ≤ 6, > 6 to ≤ 9, and ≥ 9 h/day. Multivariable logistic regression analysis was conducted.

RESULTS: Data on 13,210 adults aged ≥ 65 years [mean (SD) age 72.6 (11.3) years; 55.0% females] were analyzed. In the overall sample, compared to > 6 to ≤ 9 h/day of sleep duration, > 9 h/day was associated with 1.70 (95% CI 1.15-2.51) and 1.75 (95% CI 1.08-2.84) times higher odds for sarcopenia and severe sarcopenia, respectively. No significant associations were observed among males, but associations were particularly pronounced among females [i.e., OR = 2.19 (95% CI 1.26-3.81) for sarcopenia, and OR = 2.26 (95% CI 1.20-4.23) for severe sarcopenia].

CONCLUSIONS: Long sleep duration was associated with an increased odds of sarcopenia and severe sarcopenia in LMICs, particularly in females. Future studies should investigate whether addressing long sleep duration among females can lead to lower risk for sarcopenia onset in LMICs.

Original languageEnglish
Pages (from-to)1573-1581
Number of pages9
JournalAging Clinical and Experimental Research
Issue number7
Early online date1 Feb 2022
Publication statusPublished online - 1 Feb 2022

Bibliographical note

Funding Information:
This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323-08-CN-0020, Y1-AG-1005-01 and through research grants R01-AG034479 and R21-AG034263.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.


  • Low- and- middle income countries
  • Older adults
  • Sarcopenia
  • Sleep problems
  • Prevalence
  • Cross-Sectional Studies
  • Humans
  • Male
  • Sarcopenia/epidemiology
  • Sleep
  • Female
  • Developing Countries
  • Hand Strength


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