Sarcopenia and fall-related outcomes in Chinese adults aged 45 years or older: a longitudinal cohort study

Sarcopenia, the progressive loss of muscle mass and function, is a significant health concern in middle-aged and older adults, potentially linked to adverse outcomes like falls and fractures. A cohort study was conducted utilizing participants aged ≥ 45 years from CHARLS. Sarcopenia was defined using established criteria. Primary outcomes were isolated falls, isolated hip fractures, and composite outcomes. Associations were assessed using multivariable Cox regression (adjusted for confounders), propensity score matching (PSM), and inverse probability weighting (IPW), reporting hazard ratios (HRs) and 95% confidence intervals (CIs).Conduct sensitivity analyses such as stratification to control for confounding. Among 6,939 participants (42.6% with sarcopenia), 10-year incident rates were 39.7% for isolated falls, 3.3% for isolated hip fractures, and 1.7% for composite outcomes. Sarcopenia was persistently associated with an increased risk of isolated falls across all analyses (adjusted HR = 1.20, 95% CI:1.10–1.31, p < 0.01; PSM HR = 1.19, p < 0.01; IPW HR = 1.26, p < 0.001). For isolated hip fractures, significant associations were found in adjusted (HR = 1.60, 95% CI:1.17–2.17, p = 0.003) and IPW analyses (HR = 1.78, p = 0.01), but not PSM (HR = 0.99, 95%CI:0.68–1.44, p = 0.958). No significant association was found between sarcopenia and composite outcomes.Sensitivity analysis confirmed the robustness of the results. Sarcopenia is a significant risk factor for falls in middle-aged and older Chinese adults. Its association with hip fractures requires further investigation due to inconsistent findings across analytical methods.