Prevalence and factors associated with sarcopenia risk among older adults with diabetes: an exploratory network...

Previous research has overlooked the complex interactions of factors influencing sarcopenia risk. Therefore, this study aimed to identify prevalence and factors associated with sarcopenia risk in older adults with diabetes and to determine whether these associations differ by age and diabetes duration.

This cross-sectional study included 312 older adults with diabetes in Guangzhou, China. Sarcopenia risk was assessed using Asian Working Group for Sarcopenia (AWGS) 2019 guideline. Data were collected on demographics, disease-related, physiological, psychological (unhappiness, apathy and anxiety, loss of hope and morale, energy loss) and social factors (objective support, subjective support, utilization of support). Mixed graphical model was constructed to analyze factors associated with sarcopenia risk. Network analyses stratified by patients' age and diabetes duration were also conducted for comparative analysis.

The prevalence of high risk for sarcopenia was 56.4%. Network analysis identified unhappiness as the most central factor associated with sarcopenia risk (r_s=2.012), followed by objective support (r_s=1.485) and energy loss (r_s=0.633). The covariates demonstrated a high accuracy (70.2%) in predicting sarcopenia risk categories. Subgroup analysis revealed patients aged 60-70 years and diabetes duration < 10 years reflected overall findings. Patients ≥ 71 years showed nutritional status (r_s=1.881) as the dominant node. Among those with diabetes duration ≥ 10 years, energy loss (r_s=1.460) was the primary factor. Objective support remained the second strongest factor in all subgroups except in the < 10-year diabetes duration group.

Our findings highlight unhappiness as the key factor in the sarcopenia risk network among older adults with diabetes. The key factors vary across different age and diabetes duration, highlighting the necessity of tailoring intervention strategies to individual patients. Objective support demonstrates a broad impact on sarcopenia risk across this population.