Sarcopenia and sleep duration with the likelihood of successful aging among older adults in China: a prospective cohort study.

BACKGROUND

Sarcopenia and sleep duration have emerged as crucial health-related factors in geriatric research. This study aimed to investigate the independent and joint associations of sarcopenia and sleep duration with successful aging and its components among older adults in China.

METHODS

A dynamic 10-year cohort of 6,410 adults aged ≥ 60 was constructed using the China Health and Retirement Longitudinal Study (CHARLS) data (2011-2020). Sarcopenia was identified using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Sleep duration encompassed nighttime sleep and naps. Cox proportional hazards regression and multivariable logistic regression were used to examine the associations. Sensitivity analyses were conducted using alternative definitions of successful aging and applying generalized linear mixed models.

RESULTS

The mean age of the participants at baseline was 67.05 ± 6.30 years. Compared to non-sarcopenia adults, those with possible sarcopenia and sarcopenia had a 39% (HR = 0.61, 95%CI: 0.52-0.71) and 45% (HR = 0.55, 95%CI: 0.45-0.67) lower likelihood of successful aging, respectively, with a significant dose-response relationship (P < 0.001). Sleep durations of 6-8 h, 8-9 h and ≥ 9 h increased the likelihood of successful aging by 49% (HR = 1.49, 95% CI: 1.25-1.77), 46% (HR = 1.46, 95% CI: 1.19-1.78) and 48% (HR = 1.48, 95% CI: 1.21-1.91), respectively, compared to < 6 h sleep. Joint analysis revealed that individuals with sarcopenia and short sleep (< 6 h) had the lowest probability of successful aging (HR = 0.38, 95% CI: 0.28-0.52), suggesting a cumulative detrimental effect. Both possible sarcopenia and sarcopenia was associated with decreased likelihood of no major disease, no disability, high cognitive function, and no depressive symptoms in the successful aging. Subgroup analyses showed consistent effects of sarcopenia across demographic groups. Sensitivity analyses confirmed the robustness and reliability of the primary findings.

CONCLUSIONS

Sarcopenia and short sleep duration independently and jointly hinder successful aging. Community sarcopenia screening integrated into primary care and advocating adequate sleep duration may served as a cost-effective successful aging strategy.