Sarcopenia Screening in Community-Dwelling Older Adults in Indonesia: Implications for Integrated Care Strategies to Enhance Quality of Life

Background Sarcopenia, age-related muscle loss, diminishes quality of life (QoL) in older adults. In Indonesia, data on its prevalence and impact in semi-urban communities are limited. This study aimed to determine the prevalence of sarcopenia risk and its association with QoL among community-dwelling older adults in Indonesia. Methods This cross-sectional study included 510 community-dwelling older adults (≥60 years). Sarcopenia risk was assessed using the Strength, Assistance with walking, Rising from a chair, Climbing stairs, Falls, and Calf circumference (SARC-CalF) tool. Health-related QoL was measured with the EuroQol 5-Dimension 5-Level (EQ-5D-5L) instrument. Demographic, socioeconomic, and clinical variables were self-reported. Spearman's correlation and multivariate linear regression identified QoL predictors. Structural equation modeling (SEM) evaluated pathways linking comorbidities, sarcopenia, and QoL. Results High sarcopenia risk was observed in 44.9% of participants. Sarcopenia risk correlated inversely with QoL (ρ = -0.69, p < 0.001). In multivariate regression, sarcopenia risk, advanced age, low income, and comorbidity burden independently predicted lower QoL (Adjusted R 2 = 0.58). SEM demonstrated that comorbidities affected QoL both directly and indirectly via sarcopenia, with a significant mediation effect. Interaction analyses revealed steeper QoL declines with increasing sarcopenia risk among females and the oldest-old. Conclusion Sarcopenia risk is highly prevalent and strongly associated with lower QoL among Indonesian older adults, mediating much of the impact of chronic comorbidities. Routine sarcopenia screening using SARC-CalF and integrated interventions addressing muscle health, chronic disease management, and socioeconomic support are warranted.