Abstract: Objective To investigate the relationship between sarcopenia and fall risk in Chinese elderly individuals and to analyze potential gender differences. Methods A prospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS). Individuals aged ≥60 years who participated in the 2011, 2013, 2015, 2018, and 2020 surveys were selected. Based on the 2019 Asian Consensus on the Diagnosis and Treatment of Sarcopenia, elderly individuals were categorized into four groups: no sarcopenia, possible sarcopenia, sarcopenia, and severe sarcopenia. Kaplan-Meier analysis was used to evaluate the cumulative incidence risk of falls across different sarcopenia statuses. Cox proportional hazards regression models were employed to analyze the relationship between sarcopenia and fall risk, and subgroup analyses were performed to assess gender differences. Results A total of 3 290 older adults ≥60 years of age were enrolled. During the 9-year follow-up, 1 665 (50.6%) experienced at least one fall. The fall incidence rates for the no sarcopenia, possible sarcopenia, sarcopenia, and severe sarcopenia groups were 44.7%, 52.8%, 57.5%, and 71.4%, respectively. After adjusting for covariates, Cox proportional hazards regression analysis showed that compared to the no sarcopenia group, the possible sarcopenia, sarcopenia, and severe sarcopenia groups had increased fall risks, with HRs (95% CI) of 1.17 (1.04-1.31), 1.27 (1.06-1.53), and 1.62 (1.25-2.10), respectively. Subgroup analysis by gender revealed a significant association between sarcopenia and fall risk in males (P<0.05 or P<0.01), while no significant association was observed in females (P>0.05). Conclusion Sarcopenia is significantly associated with fall risk in Chinese elderly individuals, with a more pronounced association in males.

Key words: Sarcopenia, Falls, Elderly, Cohort study, Cox proportional hazards regression model