Prevalence of Sarcopenia and Factors Associated with Body Composition and Protein Intake in Institutionalized Older Adults from Three Long-Term Care Facilities in Loja, Ecuador: A Cross-Sectional Study

Vollständiger Abstract

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Background/Objectives: Sarcopenia is a common public health problem in older adults and is associated with an increased risk of morbidity and mortality, particularly in institutionalized populations. This study aimed to determine the prevalence of sarcopenia in institutionalized older adults, assess the adequacy of protein intake in terms of quantity and quality, and identify factors associated with its presence. Methods: An observational, analytical, cross-sectional study was conducted in three institutional care homes in Loja canton, Ecuador, between 2024 and 2025. A total of 44 older adults aged ≥65 years were included. Sarcopenia was diagnosed according to the EWGSOP2 criteria, and protein intake was assessed using the direct food-weighing method over three days. Descriptive, comparative, and binary logistic regression analyses were performed. Results: The prevalence of confirmed and severe sarcopenia was 61.3%. Severe sarcopenia was more frequent in men, whereas probable sarcopenia was more frequent in women. Participants with sarcopenia presented with lower skeletal muscle mass, skeletal muscle index, and muscle strength. Protein intake was generally insufficient compared with international recommendations, although protein quality was predominantly high or very high. Higher skeletal muscle mass and higher body mass index were independently associated with a lower likelihood of sarcopenia. Conclusions: Sarcopenia in institutionalized older adults appears to be more closely associated with body composition and overall nutritional status than with protein quantity or quality alone. These findings support a comprehensive approach to the prevention and management of sarcopenia that combines adequate nutrition with tailored physical exercise interventions.