Long-term impact of sarcopenia on functional decline and mortality in community-dwelling older adults: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational cohort studies
PubMed 41586241 · doi:10.3389/fnut.2025.1652386
What was done
Authors conducted a systematic review and meta-analysis following PRISMA and MOOSE guidelines (PROSPERO CRD42024595362), searching seven databases through September 30, 2025. They included cohort studies of community-dwelling adults aged 60 years and older that assessed baseline sarcopenia using recognized diagnostic criteria and followed participants for at least one year to report on functional decline or all-cause mortality. Meta-analyses used common or random-effects models depending on heterogeneity.
What was found
Across 39 included cohort studies with 76,151 participants, baseline sarcopenia was significantly associated with all-cause mortality (29 publications, OR = 1.79, 95% CI: 1.55 to 2.06) and functional decline (16 publications, OR = 1.90, 95% CI: 1.55 to 2.32). Significant associations were found for both physical functional decline (OR = 1.91, 95% CI: 1.52 to 2.40) and cognitive/psychological functional decline (OR = 2.03, 95% CI: 1.35 to 3.05). Subgroup analyses demonstrated consistent associations across muscle mass assessment methods (DXA, BIA, and CT). Moderate to high heterogeneity was observed.
Why it matters
This study provides large-scale longitudinal evidence establishing sarcopenia as a strong prognostic indicator for mortality and functional deterioration across physical and cognitive domains in community-dwelling older populations.
Limits
All included data derive from observational cohort studies, precluding causal conclusions. Statistical heterogeneity was moderate to high across the pooled analyses. The abstract does not specify whether effect estimates were uniformly adjusted for baseline confounders or comorbidities, nor does it provide the specific duration of follow-up beyond the one-year minimum threshold.
Cited by
- supports A 2025 cohort study of over 130,000 people showed that low lean muscle mass was a strong predictor of increased mortality.