In total, 743 individuals were enrolled in this study. We excluded four participants who were not assessed for sarcopenia. Thus, the final study population included 739 participants (279 men and 460 women; Figure 1).
The age range of the included participants was 80–94 years (mean=73.78, SD=7.46 years). Using the Ishii Screening Scale algorithm, 287(38.84%) participants were identified as sarcopenia, 119 (41.46%) were males, and 168 (37.17%) were females (Table 1). In a comparison of demographic characteristics between sarcopenia group and non-sarcopenia group, there were significant differences in age (Z=-10.039, P<0.05), nationality (χ2=4.480, P<0.05), education status (Z=-2.760, P <0.05), and living conditions (χ2=25.788, P <0.05).
Table1. Demographic characteristics of 739 elderly n=739 (n %)
Characteristics
|
Frequency(%)
|
Age
|
|
|
|
60~69
|
216(29.23)
|
|
70~79
|
340(46.01)
|
|
≥80
|
183(24.76)
|
Gender
|
|
|
|
Male
|
279(37.75)
|
|
Female
|
460(62.25)
|
Nationality
|
|
|
|
Han
|
684(92.56)
|
|
Minority
|
55(7.44)
|
Educational level
|
|
|
|
Primary school
|
376(50.86)
|
|
Junior middle school
|
209(28.28)
|
|
Senior high school
|
86(11.64)
|
|
Junior college or above
|
68(9.22)
|
Per capita monthly income of the family
|
|
|
|
Less than 1000 RMB
|
84(11.37)
|
|
1001~3000RMB
|
189(25.57)
|
|
3001~5000RMB
|
373(50.48)
|
|
More than 5001 RMB
|
93(12.58)
|
Sports conditions*
|
|
|
|
Yes
|
575(77.81)
|
|
No
|
164(22.19)
|
Living conditions
|
|
|
|
Lived alone
|
201(27.19)
|
|
Lived with their families
|
538(72.81)
|
The age range of the included participants was 80–94 years (mean=73.78, SD=7.46 years). Using the Ishii Screening Scale algorithm, 287(38.84%) participants were identified as sarcopenia, 119(41.46%) were males, and 168(37.17%) were females (Table 1). In comparison of demographic characteristics between sarcopenia and non-sarcopenia groups, significant differences observed in age (Z=-10.039, P<0.05), nationality (χ2=4.480, P <0.05), education status (Z=-2.760, P <0.05), and in living conditions (χ2=25.788, P <0.05).
Comparison of nutritional status and mental health between sarcopenia group and non-sarcopenia group
The nutritional status of the elderly between the two groups was significantly different (P <0.05). There were significant differences in depressive and anxiety symptoms between the two groups (P <0.05), as shown in Table 2.
Table 2 Comparison of nutritional status between sarcopenia group and non-sarcopenia group of elderly people in community n=739(n%)
Variable
|
Total (n=739)
|
Sarcopenia (n=287)
|
Non-sarcopenia (n=452)
|
χ2/Z
|
P-value
|
Nutrition
|
|
|
|
|
|
|
|
Malnutrition
|
26
|
20(6.97)
|
6(1.33)
|
-6.989
|
<0.001
|
|
Malnutrition riska
|
294
|
148(51.57)
|
146(32.30)
|
|
Good nutritional statusb、c
|
419
|
119(41.46)
|
300(66.37)
|
Depressive symptoms
|
|
|
|
|
5.063
|
0.024
|
|
Nondepressive symptoms
|
487
|
175(35.93)
|
312(64.07)
|
|
|
|
Depressive symptoms
|
252
|
112(44.44)
|
140(55.56)
|
|
|
Anxiety symptoms
|
|
|
|
|
4.360
|
0.037
|
|
Anti-anxiety symptoms
|
534
|
195(36.52)
|
339(63.48)
|
|
|
|
Anxiety symptoms
|
215
|
92(42.79)
|
113(57.21)
|
|
|
Comparison of social participation between sarcopenia group and non-sarcopenia group
There was no difference in social activities and the frequency of participating in social activities between sarcopenia group and the non-sarcopenia group. The comparison between the types of participating in social activities shows that the elderly in the two groups have significant differences in participating family activities (P <0.05), as shown in Table 3.
Table 3. Comparison of participation in different types of social activities between sarcopenia group and non-sarcopenia group of elderly people in community n= 661 (n %)
Variable
|
Total (n=661)
|
Sarcopenia (n=252)
|
Non-sarcopenia (n=409)
|
χ2
|
P
|
Interpersonal activities
|
|
|
|
|
0.662
|
0.416
|
|
Yes
|
573
|
215(85.32)
|
358(87.53)
|
|
|
|
No
|
88
|
37(14.68)
|
51(12.47)
|
|
|
Social and cultural activities
|
|
|
|
|
1.93
|
0.165
|
|
Yes
|
436
|
158(62.69)
|
278(67.97)
|
|
|
|
No
|
225
|
94(37.31)
|
131(33.03)
|
|
|
Socioeconomic activities
|
|
|
|
|
0.553
|
0.457
|
|
Yes
|
14
|
4(1.59)
|
10(2.44)
|
|
|
|
No
|
647
|
248(98.41)
|
399(97.56)
|
|
|
Family wide activities
|
|
|
|
|
13.08
|
<0.001
|
|
Yes
|
97
|
21(8.33)
|
76(18.58)
|
|
|
|
No
|
564
|
231(91.67)
|
333(81.42)
|
|
|
Correlation analysis
The results showed that age, depressive symptoms, and anxiety symptoms were positively correlated with sarcopenia (P <0.05), whereas education level, living conditions, nutritional status, and social participation activity classification were negatively correlated with sarcopenia (P <0.05), as shown in Table 4.
Table 4. Spearman correlation analysis of sarcopenia and related factors in elderly people in the community
Variables
|
r
|
P
|
Age
|
0.404
|
0.000
|
Gender
|
-0.061
|
0.098
|
Nationality
|
-0.079
|
0.032
|
Education Status
|
-0.102
|
0.006
|
Per capita monthly income of the family
|
0.003
|
0.934
|
Physical exercise
|
-0.039
|
0.285
|
Living condition
|
-0.187
|
0.000
|
Nutritional status
|
-0.257
|
0.000
|
Depressive symptoms
|
0.083
|
0.024
|
Anxiety symptoms
|
0.077
|
0.037
|
Whether participate in social activities
|
-0.043
|
0.248
|
Frequency of participation in social activities
|
-0.027
|
0.456
|
Classification of social participation activities
|
-0.125
|
0.001
|
Construction of structural equation model for related factors of sarcopenia in the elderly community
The maximum likelihood estimation method was tested using Amos24.0, and the initial model was continuously fitted. The insignificant variables and paths were removed during the model correction, and the final model showed adequate goodness-of-fit indices. (CMIN/DF=2.254<3.000,RMSEA=0.041<0.05,AGFI=0.952>0.900,GFI=0.973>0.900,CFI=0.948>0.900,NFI=0.913>0.900,IFI=0.949>0.900). The overall fitting effect of this model is the closest to the reference standard among all models, and the model has statistical significance (P <0.01).
The hypothesis test of the modified model showed that except for the path of anxiety symptoms affecting sarcopenia(P=0.479), the other paths were all P <0.05, the absolute value of C.R. >1.96, and the differences of all path coefficients were statistically significant (P <0.05). The results of this model path can reflect the relationship between sarcopenia, depressive symptoms, nutritional status, and social participation, as shown in Table 4.
The results indicated that nutritional status, depressive symptoms, and social participation directly impacted sarcopenia. The effect values were respectively -0.322, -0.096, and 0.093. The data in Table 5 shows no indirect effect among all variables.
Table 4. Regression path test of the effects of nutritional status, psychological status, and social participation on sarcopenia
Path
|
Nonstandard coefficient
|
S.E.
|
Standard coefficient
|
C.R.
|
P
|
Social participation→Depressive symptoms
|
-2.414
|
0.555
|
-0.156
|
-4.352
|
<0.001
|
Social participation→Anxiety symptoms
|
-1.539
|
0.464
|
-0.116
|
-3.315
|
<0.001
|
Social participation→Nutritional status
|
1.370
|
0.335
|
0.140
|
4.090
|
<0.001
|
Nutritional status→Sarcopenia
|
-3.406
|
0.374
|
-0.322
|
-9.104
|
<0.001
|
Depressive symptoms→Sarcopenia
|
0.641
|
0.285
|
0.096
|
2.249
|
0.025
|
Anxiety symptoms→Sarcopenia
|
-0.232
|
0.328
|
-0.030
|
-0.708
|
0.479
|
Social participation→Sarcopenia
|
9.653
|
3.548
|
0.093
|
2.721
|
0.007
|
Table 5 The effects of nutritional status, psychological status, and social participation on sarcopenia
Path
|
Effect
|
Effect value
|
S.E.
|
95% confidence interval
|
Lower
|
Upper
|
Social participation→Depressive symptoms
|
Direct effect
|
-0.156
|
0.050
|
-0.259
|
-0.063
|
Social participation→Anxiety symptoms
|
Direct effect
|
-0.116
|
0.044
|
-0.211
|
-0.038
|
Social participation→Nutritional status
|
Direct effect
|
0.001
|
0.047
|
0.056
|
0.236
|
Nutritional status→Sarcopenia
|
Direct effect
|
-0.322
|
0.036
|
-0.390
|
-0.249
|
Depressive symptoms→Sarcopenia
|
Direct effect
|
0.096
|
0.043
|
0.011
|
0.178
|
Anxiety symptoms→Sarcopenia
|
-
|
-0.030
|
0.044
|
-0.114
|
0.055
|
Social participation→Sarcopenia
|
Direct effect
|
0.093
|
0.038
|
0.025
|
0.174
|