Unseen burden: Prevalence and determinants of possible sarcopenia in Indonesian older adults – a secondary data analysis

Background Indonesia is experiencing rapid population aging, raising concern about muscle weakness in later life; possible sarcopenia offers early identification through low handgrip strength. Objective To estimate the prevalence of possible sarcopenia and its determinants among older adults in Indonesia. Methods This secondary analysis used baseline data from the Indonesian Longitudinal Aging Survey 2023 and included adults aged sixty years or older with valid handgrip measurements. Possible sarcopenia followed the Asian Working Group for Sarcopenia 2019 thresholds using the maximum of two trials per hand. Covariates included sociodemographic, behavioral, functional, and clinical factors. We applied descriptive statistics, bivariate tests, and multivariable logistic regression, with probit average marginal effects. Sampling weights were unavailable in the public-use microdata; we treated enumeration areas as the primary sampling units, with available stratification and no weights; estimates were unweighted, and standard errors were design-based (survey-corrected). Results Among 1,598 participants, the prevalence of possible sarcopenia was 51.1%. Older age, low physical performance, and urban residence were associated with higher odds. Higher body mass index and better cognition were associated with lower odds. A prespecified sex-by-body mass index interaction suggested attenuation of the protective association of body mass index among women. Conclusion Possible sarcopenia is common among older Indonesians and is patterned by age, body composition, cognition, functional status, and residential context. Community health services, including community nursing services, can integrate routine handgrip assessment with brief interventions on strength activities, nutrition, and cognitive engagement to identify risk early and inform preventive care.