Abstract
BACKGROUND: Sarcopenia is a progressive musculoskeletal disorder linked to physical disability, reduced quality of life, and increased mortality in older adults. While malnutrition is a well-established risk factor, understanding the behavioral (i.e., individual choices and habits) and social determinants of sarcopenia is crucial for designing effective public health strategies. This study investigates the associations between physical activity, sociodemographic and socioeconomic factors, and risk of sarcopenia in older adults living in Ceará, northeast Brazil. METHODOLOGY: This cross-sectional study included 736 older adults registered in primary health care units in the cities of Icó and Tauá, Ceará, from September 2022 to March 2023. Risk of sarcopenia was measured using the SARC-F questionnaire. Physical activity was assessed with the International Physical Activity Questionnaire for the Elderly (IPAQ-E), nutritional status with the Mini Nutritional Assessment, and sociodemographic and socioeconomic information through an adapted structured questionnaire. All instruments were administered in person by trained personnel. We analyzed associations using chi-square tests and logistic regression models. RESULTS: Lower physical activity levels were strongly associated with greater odds of screening positive for risk of sarcopenia (OR = 7.99, 95% CI: 5.00-12.77). We also found significant associations for sex, marital status, and occupation. Specifically, women, individuals who were widowed or divorced, and those without an occupation were more likely to screen positive for risk of sarcopenia. Nutritional status was, however, not significantly associated with risk for sarcopenia. CONCLUSIONS: Our findings demonstrate the importance of promoting physical activity and reducing social inequalities to prevent sarcopenia in aging populations. Public health strategies should be tailored to account for both behavioral and social determinants of health, with particular attention to the intersection of sex, social support, and occupation. Further longitudinal research is needed to clarify how these factors interact over time in the development of sarcopenia.