Effect of statin use on the development of sarcopenia in older adults: A systematic review and meta-analysis

Given the ongoing debate regarding whether statin therapy contributes to muscle decline in older adults, this study aims to synthesize the available observational evidence on the association between statin use and the development of sarcopenia through a systematic review and meta-analysis. Following PRISMA 2020 and MOOSE guidelines, searches were conducted in PubMed, Scopus, and Web of Science. Effect estimates from eligible observational studies were extracted and pooled using random-effects models with the Paule–Mandel estimator. One meta-analysis assessed the association between statin exposure and sarcopenia; a meta-regression explored whether study-level factors modified the relationship. Ten studies met the inclusion criteria (total n = 9080), enrolling predominantly adults aged ≥60 years from European and Asian populations. The meta-analysis yielded a pooled odds ratio of 0.82 (95% CI: 0.16–4.05), indicating no statistically significant association between statin use and sarcopenia. Heterogeneity was extremely high (I 2 = 99.6%). The meta-regression, based on available moderators (e.g., malnutrition, obesity, disability level), did not identify significant predictors of variability across studies. Statin exposure was not associated with an increased risk of sarcopenia in older adults. Although estimates ranged from potentially harmful to mildly protective, high heterogeneity and limited methodological consistency restrict interpretability. • Observational evidence on statin use and sarcopenia was systematically synthesized. • Ten studies ( n = 9080) in older adults were included following PRISMA and MOOSE. • Statin exposure was not significantly associated with sarcopenia risk (OR = 0.82). • Substantial heterogeneity across studies limited interpretability of pooled estimates. • Larger harmonized longitudinal studies are needed to clarify patient-specific risks.