Glycated Hemoglobin, Lifestyle, and Sarcopenia in Rural Older Adults: A Cross-Sectional Analysis

Sarcopenia threatens independence in rapidly aging rural populations, yet its metabolic and lifestyle correlates remain under-characterized in Korea. We analyzed rural residents aged ≥ 65 years from the 2023 Korea National Health and Nutrition Examination Survey (n = 398). Sarcopenia was defined using Asian Working Group for Sarcopenia (AWGS) 2019 criteria as low appendicular muscle mass plus low handgrip strength. Covariates included sociodemographic characteristics, smoking, past-year alcohol consumption, physical activity, body mass index, hypertension, diabetes, and glycated hemoglobin (HbA1c). Multivariable logistic regression estimated adjusted odds ratios (aORS). Sarcopenia prevalence was 15.1%. Higher odds were observed among participants aged > 76 years (adjusted odds ratio [aOR] 2.43, 95% confidence interval [CI] 1.29-4.59) and those with HbA1c ≥ 7.0% (aOR 3.24, 95% CI 1.42-7.40). Lower odds were observed among those meeting the physical activity guideline, those with body mass index ≥ 25 kg/m², and those reporting past-year alcohol use. These findings support nurse-led risk stratification in rural primary care using handgrip assessment, simple anthropometrics, HbA1c review, and brief activity counseling.