Journal of Preventive Medicine and Public Health

Original Articles

Associations Between Poor Appetite, Sarcopenia, and Cognitive Function in Community-dwelling Malaysian Older Adults: Sook Yee Lim, Yoke Mun Chan, Maw Pin Tan, Shahrul Bahyah Kamaruzzaman, Rahimah Ibrahim; J Prev Med Public Health. 2025;58(6):589-598. Published online November 6, 2025; DOI: https://doi.org/10.3961/jpmph.25.196

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Abstract Summary PDF: Objectives
This study aimed to explore the associations between poor appetite, sarcopenia, and cognitive function among Malaysian older adults.
Methods
This nationwide study involved 1086 community-dwelling older adults aged 55 years and above. Poor appetite was defined using a self-reported question, while cognitive function was assessed with the Montreal Cognitive Assessment. Sarcopenia was identified based on handgrip strength, 6-meter gait speed, and muscle mass, in accordance with the Asian Working Group for Sarcopenia 2019 criteria. Associations between poor appetite, sarcopenia, and cognitive function were analyzed using both univariate and multivariate analyses.
Results
Multivariate analysis revealed that handgrip strength (β=0.067, p=0.012) and gait speed (β=1.080, p=0.017) were significantly associated with cognitive function after adjusting for confounders such as age, ethnicity, marital status, education, and alcohol and smoking consumption. However, no significant association was observed between poor appetite and cognitive function, nor was any moderation effect found between poor appetite and sarcopenia-related traits on cognitive function.
Conclusions
Our study confirms that low muscle strength and reduced physical performance are significantly associated with an increased risk of cognitive impairment among community-dwelling older adults. These findings underscore the critical importance of muscle strength and physical performance in preserving cognitive function—a decline that is not inevitable with age. Routine screening and early detection of muscle health and cognitive function are essential, and should be followed by intervention strategies targeting muscle health to mitigate cognitive decline in aging populations.; Summary

Key Message
Lower muscle strength and slower gait speed were independently associated with poorer cognitive function in Malaysian older adults, while poor appetite showed no direct or moderating effect on cognition. These findings underscore the importance of routine screening and early interventions targeting muscle health to help prevent cognitive decline in aging populations.

Knowledge of Sarcopenia and Associated Factors Among the Malaysian General Public: A Cross-sectional Study: Soon Lean Keng, Noor Hazlisa Che Seman, K.Mangaikresh Krishnan, Chook Jack Bee, Joyce Leong Whye Sook, Siti Fairuz Ismail, Ooi Pei Boon, Peh Suat Cheng; J Prev Med Public Health. 2023;56(2):164-171. Published online March 5, 2023; DOI: https://doi.org/10.3961/jpmph.22.399

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Objectives
Sarcopenia has emerged as a significant aging-related disease that affects many facets of societal-level and patient-level public health. This study analysed knowledge of sarcopenia and associated socio-demographic factors among the general public of Malaysia in order to effectively improve its prevention and countermeasures.
Methods
A cross-sectional online survey was conducted in Selangor, Malaysia, using Google Forms among 202 Malaysian adults from January 1, 2021 to March 31, 2021. Descriptive statistics were used to analyse the socio-demographic characteristics and knowledge scores. The continuous variables were evaluated using the independent t-test, Mann–Whitney test, and one-way analysis of variance test. The Spearman correlation coefficient was employed to determine the correlation between socio-demographic characteristics and knowledge score levels.
Results
The final analysis included 202 participants. The mean±standard deviation age was 49.03±12.65. Only 6.9% of participants had good knowledge of sarcopenia and were aware of sarcopenia’s characteristics, consequences, and treatments. Post-hoc comparisons using the Dunnett T3 test showed statistical significance in mean knowledge score and age group (p=0.011) and education level (p≤0.001). The Mann–Whitney test revealed that gender (p=0.026) and current smoking status (p=0.023) significantly influenced knowledge scores.
Conclusions
The general public’s knowledge of sarcopenia was found to be poor to moderate and associated with age and education status. Therefore, education and interventions by policymakers and healthcare professionals to improve public knowledge of sarcopenia in Malaysia are needed.

Summary

Citations

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Association Between Low Muscle Mass and Non-alcoholic Fatty Liver Disease Diagnosed Using Ultrasonography, Magnetic Resonance Imaging Derived Proton Density Fat Fraction, and Comprehensive NAFLD Score in Korea: Hun Ju Lee, Jae Seung Chang, Jhii Hyun Ahn, Moon Young Kim, Kyu-Sang Park, Yeon-Soon Ahn, Sang Baek Koh; J Prev Med Public Health. 2021;54(6):412-421. Published online October 22, 2021; DOI: https://doi.org/10.3961/jpmph.21.387

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Abstract Summary PDF Supplementary Material

Objectives
Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent metabolic disease. Muscle is known to influence NAFLD development. Therefore, this study aimed to determine the relationships among low muscle mass, NAFLD, and hepatic fibrosis using various definitions of low muscle mass and NAFLD diagnostic methods, including magnetic resonance imaging-based proton density fat fraction (MRI-PDFF).
Methods
This cross-sectional study included 320 participants (107 males, 213 females) from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population cohort. Muscle mass was assessed using whole-body dual-energy X-ray absorptiometry and adjusted for the height squared, body weight, and body mass index (BMI). NAFLD was diagnosed using ultrasonography (US), MRI-PDFF, and the comprehensive NAFLD score (CNS). Hepatic fibrosis was assessed using magnetic resonance elastography. Multivariable logistic and linear regression analyses were performed to determine the aforementioned associations.
Results
According to US, 183 participants (57.2%) had NAFLD. Muscle mass adjusted for body weight was associated with NAFLD diagnosed using US (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.70 to 5.31), MRI-PDFF (OR, 2.00; 95% CI, 1.13 to 3.53), and CNS (OR, 3.39; 95% CI, 1.73 to 6.65) and hepatic fibrosis (males: β=-0.070, p<0.01; females: β=-0.037, p<0.04). Muscle mass adjusted for BMI was associated with NAFLD diagnosed by US (OR, 1.71; 95% CI, 1.02 to 2.86) and CNS (OR, 1.95; 95% CI, 1.04 to 3.65), whereas muscle mass adjusted for height was not associated with NAFLD.
Conclusions
Low muscle mass was associated with NAFLD and liver fibrosis; therefore, maintaining sufficient muscle mass is important to prevent NAFLD. A prospective study and additional consideration of muscle quality are needed to strengthen the findings regarding this association.

Summary

Korean summary
비알콜성 간질환은 대사질환 중 하나로 적은 근육양과의 연관성이 지속적으로 제시되었으나, 기존 연구들에서 일관되지 않은 결과를 보여주었다. KoGES-ARIRANG 코호트의 320명을 대상으로 초음파·MRI-PDFF·CNS 진단기준을 사용하여 단면연구를 수행한 결과, 세 진단기준에서 모두 적은 근육량과 비알콜성 간질환 사이에 연관성이 나타났다.

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Systematic Review

Prevalence of Sarcopenia Among the Elderly in Korea: A Meta-Analysis: Yoo Jin Choo, Min Cheol Chang; J Prev Med Public Health. 2021;54(2):96-102. Published online March 4, 2021; DOI: https://doi.org/10.3961/jpmph.21.046

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Abstract Summary PDF

Objectives
Sarcopenia is a common disease in the elderly population that causes disability, poor quality of life, and a high risk of death. In the current study, we conducted a meta-analysis to report basic knowledge about the prevalence of sarcopenia in the elderly in Korea.
Methods
We searched for articles in the MEDLINE, Cochrane Library, Embase, and Scopus databases published until December 28, 2020. Studies investigating the prevalence of sarcopenia in elderly Koreans aged ≥65 years were included. The methodological quality of the studies was evaluated using the Newcastle-Ottawa scale. Publication bias was evaluated using the Egger test and funnel plots.
Results
In total, 3 studies and 2922 patients were included in the meta-analysis. All 3 studies used the European Working Group on Sarcopenia in Older People criteria for the diagnosis of sarcopenia. The total prevalence of sarcopenia was 13.1-14.9% in elderly men and 11.4% in elderly women.
Conclusions
This meta-analysis is the first to estimate the pooled prevalence of sarcopenia in elderly Koreans, and its findings suggest that sarcopenia is common in this population. Therefore, attention should be paid to the prevention and control of sarcopenia.

Summary

Korean summary
본 연구에서는 노인인구에서 삶의 질 저하 및 높은 사망률을 야기시키는 흔한 질환인 근감소증의 유병률을 조사하고자 메타분석을 시행하였다. 분석에는 65세 이상 한국 노년층의 근감소증 유병률을 조사한 3건의 연구들과 총 2,922명의 대상자가 포함되었으며, 3개의 연구 모두 European Working Group on Sarcopenia in Older People criteria를 통해 근감소증을 진단하였다. 분석 결과, 근감소증의 총 유병률은 남성에서 13.1-14.9%였고, 여성에서는 11.4%였다. 이 결과는 우리나라의 노인 인구에서 근감소증이 흔하게 발생하므로 근감소증의 예방과 통제에 주의를 기울여야 함을 시사한다.

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Original Article

Associations of Sarcopenia and Sarcopenic Obesity With Metabolic Syndrome Considering Both Muscle Mass and Muscle Strength: Jihye Lee, Yeon-pyo Hong, Hyun Ju Shin, Weonyoung Lee; J Prev Med Public Health. 2016;49(1):35-44. Published online November 23, 2015; DOI: https://doi.org/10.3961/jpmph.15.055

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Abstract PDF

Objectives
We investigated the associations of sarcopenia-defined both in terms of muscle mass and muscle strength-and sarcopenic obesity with metabolic syndrome.
Methods
Secondary data pertaining to 309 subjects (85 men and 224 women) were collected from participants in exercise programs at a health center in a suburban area. Muscle mass was measured using bioelectrical impedance analysis, and muscle strength was measured via handgrip strength. Sarcopenia based on muscle mass alone was defined as a weight-adjusted skeletal muscle mass index more than two standard deviations below the mean of a sex-specific young reference group (class II sarcopenia). Two cut-off values for low handgrip strength were used: the first criteria were <26 kg for men and <18 kg for women, and the second criteria were the lowest quintile of handgrip strength among the study subjects. Sarcopenic obesity was defined as the combination of class II sarcopenia and being in the two highest quintiles of total body fat percentage among the subjects. The associations of sarcopenia and sarcopenic obesity with metabolic syndrome were evaluated using logistic regression models.
Results
The age-adjusted risk ratios (RRs) of metabolic syndrome being compared in people with or without sarcopenia defined in terms of muscle mass were 1.25 (95% confidence interval [CI], 1.06 to 1.47, p=0.008) in men and 1.12 (95% CI, 1.06 to 1.19, p<0.001) in women, which were found to be statistically significant relationships. The RRs of metabolic syndrome being compared in people with or without sarcopenic obesity were 1.31 in men (95% CI, 1.10 to 1.56, p=0.003) and 1.17 in women (95% CI, 1.10 to 1.25, p<0.001), which were likewise found to be statistically significant relationships.
Conclusions
The associations of sarcopenia defined in terms of muscle mass and sarcopenic obesity with metabolic syndrome were statistically significant in both men and women. Therefore, sarcopenia and sarcopenic obesity must be considered as part of the community-based management of non-communicable diseases.

Summary

Citations

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