Sarcopenia is a progressive syndrome associated with adverse outcomes in older adults. This study aimed to assess the prevalence of sarcopenia and its associated risk and protective factors among community-dwelling elderly individuals.

As a part of the Birjand Longitudinal Aging Study (BLAS), this retrospective cross-sectional study assesses patients older than 60 years old. Basic characteristics, nutritional status, comorbidities, and sociodemographic data were collected. Logistic regression analyses were performed to identify factors associated with sarcopenia severity.

A total of 1,348 participants (mean age: 69.73 ± 7.53 years) were classified into four groups: robust (58.85%), probable sarcopenia (31.03%), sarcopenia (4.76%), and severe sarcopenia (5.36%). On univariate analysis, being overweight or obese, any formal education, regular physical activity, and hypertension were accompanied by lower odds of sarcopenia, whereas dementia and anemia increased its odds. In the fully adjusted model, age > 70 years (OR 1.39, 95% CI 1.05-1.83) and > 80 years (OR 4.93, 95% CI 3.15-7.71), malnutrition risk (OR 1.36, 95% CI 1.02-1.82), living alone (OR 1.88, 95% CI 1.12-3.22) and dementia (OR 1.03 per 6-CIT point, 95% CI 1.01-1.05) were independent risk factors, while education lower than diploma (OR 0.63, 95% CI 0.46-0.86) and diploma (OR 0.39, 95% CI 0.22-0.67), exercise more than once per week (with different ORs regarding variable physical activity frequencies) and hypertension (OR = 0.62, 95% CI: 0.47-0.81, P-value < 0.01) were related to lower odds of sarcopenia.

Conclusions: Those aged > 70, at risk of malnutrition, and having dementia had higher odds of sarcopenia. In contrast, having an educational level of a diploma or lower, ≥ one session of physical activity per week, and having hypertension showed a reverse association with sarcopenia. Findings underscore the importance of targeted interventions to mitigate sarcopenia risk in aging populations.