Longitudinal changes of sarcopenia status and risks of cardiovascular disease and all-cause mortality

BACKGROUND AND OBJECTIVES: Little is known about the association between changes in sarcopenia status with cardiovascular disease (CVD) and all-cause mortality. We aimed to evaluate the associations between sarcopenia status changes and incident CVD and mortality in a large prospective cohort of middle-aged and older adults. METHODS: A total of 7257 participants from the China Health and Retirement Longitudinal Study 2011 were included in analyses. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Cox proportional hazards regression models were used to examine the association of changes in sarcopenia status (never, onset, remitted, and persistent) with CVD (stroke or cardiac events) and all-cause mortality. RESULTS: During a maximum follow-up period of 2 years, a total of 722 (9.95 %) respondents experienced CVD (303 stroke and 456 cardiac events), and 292 (4.02 %) deaths were identified. Compared to participants without any sarcopenia, those in the improved and persistent sarcopenia had an increased risk of CVD, with multiple-adjusted hazard ratios (95 % confidence intervals) of 1.37 (1.04-1.80) and 1.32 (1.03-1.69), respectively. Individuals with improved and persistent sarcopenia also had higher risk of stroke and cardiac events. Among participants with baseline possible sarcopenia, those who recovered to a non-sarcopenia status had a significantly lower risk of new-onset CVD and stroke, compared to those who remained in the possible sarcopenia status. CONCLUSION: Changes in sarcopenia status are associated with varying risks of new-onset CVD risk and all-cause mortality. Monitoring long-term changes in the sarcopenia should prioritize CVD prevention strategies.