ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
This article is part of the Research TopicMechanisms and Novel Treatments of Muscle WastingView all 7 articles
The Relationships between Life's Crucial 9, Life's Essential 8, and Sarcopenia in Older Adults: Multicenter Case-Control Study
Provisionally accepted
- 1Nanyang City Center Hospital, Nanyang, China
- 2Nanyang Second General Hospital, Nanyang, China
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Background: Sarcopenia, the age-related loss of muscle mass and strength, is aggravated by cardiometabolic and psychosocial burden. Life's Essential 8 (LE8) and its mental-health extension Life's Crucial 9 (LC9) quantify cardio-psycho-metabolic risk, yet their relationship with sarcopenia remains untested. Methods: Multicenter case–control study of 1,316 consecutive inpatients (≥ 65 y) enrolled 2019–2025 at two tertiary hospitals in Nanyang, China (Nanyang Central Hospital, n = 740; Nanyang Second People's Hospital, n = 576). Sarcopenia was adjudicated by AWGS-2019. LE8 and LC9 were derived from admission nicotine, diet, sleep, physical activity, BMI, blood pressure, glucose, non-HDL-C, and PHQ-9. Multivariable logistic regression, ROC, and re-classification analyses were performed, adjusted for age, sex, BMI, hemoglobin, albumin, smoking, and comorbidity. Results: Overall sarcopenia prevalence 11.81%-14.05 %. Mean LC9 was lower in sarcopenic versus non-sarcopenic participants. ROC curves showed LC9 discriminated sarcopenia better than LE8. Across low, moderate, and high categories, sarcopenia prevalence descended steeply with LC9 and modestly with LE8. Multivariable analysis confirmed both scores as independent protectors. Conclusions: LC9, a freely calculable metric integrating mental health with cardio-metabolic health, is strongly and independently associated with sarcopenia in hospitalized older adults and outperforms LE8. Routine LC9 assessment at admission may enable early identification and multimodal intervention to prevent muscle loss.
Keywords: Life's Crucial 9, Life's Essential 8, Sarcopenia, muscle mass, Grip strength, Mental Health, PHQ-9, Cardiovascular health
Received: 27 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Li, Liu, Zhang, Nie, Wang, Zhao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gengze Wang, 19337708288@163.com
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