ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1645850
The association between skeletal muscle mass and functional capacity outcomes in Chinese elderly: a national community-based study
Provisionally accepted
- The First people's Hospital of Xiaoshan District, Hangzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Maintaining functional independence in older adults is a critical public health objective. Although skeletal muscle mass is recognized as a key contributor to functional capacity outcomes, the exact relationship between them among community-dwelling older adults requires further investigation. Methods: This cross-sectional study analyzed data from 13,322 participants aged ≥65 years from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Appendicular skeletal muscle mass index (ASMI) was calculated using a validated anthropometric equation, while functional capacity outcomes were assessed using basic and instrumental activities of daily living (BADL/IADL) scores. Multivariable linear regression, generalized additive models, and threshold effect analysis were employed to evaluate associations, with adjustments for demographic, socioeconomic, lifestyle, and comorbidity factors. Results: In fully adjusted models, ASMI showed significant inverse associations with both BADL score (β = −0.072, 95% CI: −0.103 to −0.042) and IADL score (β = −0.225, 95% CI: −0.290 to −0.159). Threshold effect analysis revealed sex-specific inflection points: below 6.2 kg/m² in men and 5.2 kg/m² below in women, ASMI was negatively associated with BADL/IADL scores, whereas above these thresholds, the associations weakened or reversed. Subgroup analyses indicated stronger effects among men, urban residents, and those with stroke or cardiovascular disease. Conclusions: Muscle mass demonstrates sex-specific, non-linear associations with functional capacity outcomes in older adults, identifying critical thresholds that may inform targeted strategies to preserve independence.
Keywords: Aging, Sarcopenia, Skeletal muscle mass, functional capacity, sex differences, CLHLS
Received: 13 Jun 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Chen, Lu and Zhu. 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: Zhongxin Zhu, orthozzx@wmu.edu.cn
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.