Cross-sectional associations between physical activity and sarcopenia at different life stages: evidence from CHARLS

Sarcopenia, defined as progressive loss of skeletal muscle mass and function, is a major health issue with economic consequences in aging societies. Physical activity is recognized as preventive, but its long-term impact across different life stages is not well established. This study examined the association between lifetime physical activity and sarcopenia prevalence using nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS).

Data from the 2014 CHARLS Life History Survey were matched with 2015 cross-sectional health assessments. After excluding participants younger than 60 years or with missing data, a final sample of 6,696 individuals was analyzed. Physical activity at different life stages was assessed using a self-reported questionnaire in the 2014 Life History Survey. Sarcopenia was classified according to the AWGS 2019 criteria. Multivariate logistic regression was conducted to evaluate the association between physical activity at different life stages and sarcopenia prevalence. A significance level of 0.05 was adopted for hypothesis testing.

Among the study participants, 51.7% were without sarcopenia, 36.0% had possible sarcopenia, and 12.3% had sarcopenia. Across all life stages, individuals with sarcopenia were less likely to have engaged in regular physical activity. After adjusting for all covariates, engaging in physical activity for at least one year at any life stage was associated with a 47% lower odds of sarcopenia (OR = 0.53, 95% CI: 0.40-0.69). The strongest protective effect was observed for physical activity during middle adulthood (41-65 years) (OR = 0.36, 95% CI: 0.19-0.69), whereas physical activity in young adulthood (≤ 40 years) and older adulthood (> 65 years) showed no significant associations.

Our findings highlight that maintaining physical activity, particularly during middle adulthood, is associated with reduced risk of sarcopenia. Because physical activity was self-reported, future research should employ objective measures and longitudinal designs to confirm these associations.