Neighborhood socioeconomic inequality and sarcopenia in community-dwelling older adults: a cross-sectional study

Abstract

Background: Individual-level socioeconomic characteristics are known to predict sarcopenia, but little is known about how the neighborhood context shapes this debilitating problem among older adults. This study examined the association between neighborhood socioeconomic inequality and sarcopenia. Materials and Methods: Data from three impact evaluation studies aimed at promoting healthy aging by using the WHO Integrated Care for Older People Model, tailored exercise training, and social prescribing strategies. A total of 1650 older adults (aged 60 or above) were included in this secondary data analysis. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 algorithm. A neighborhood socioeconomic status (nSES) index was constructed using a weighted combination of seven validated neighborhood-level socioeconomic indicators derived from government data across 292 Tertiary Planning Units in Hong Kong. The index was categorized into distribution-based tertiles as high (T1), moderate (T2), and low (T3). Logistic regression analysis identified the association between nSES and sarcopenia, adjusting for age, gender, body mass index, and individual-level socioeconomic characteristics. Results: Among the participants, 11.03% (n = 182) were diagnosed with sarcopenia. Compared with the high nSES tertiles (T1), the lower ones showed higher odds of sarcopenia after adjustment for age, sex, body mass index, and individual-level socioeconomic characteristics (T2: adjusted OR [aOR] = 1.49 [95% CI, 0.85–2.64], T3: aOR = 1.68 [95% CI, 1.02–2.74]). Conclusions: This is the first study to identify the negative relationship between comprehensive nSES and the prevalence of sarcopenia. The findings highlight the need to develop socio-environmental sensitive risk stratification and preventive care to manage later-age sarcopenia.