Prevalence of Pre-sarcopenia Among Postmenopausal Women Younger Than 65 Years

Nalina Orprayoon, MD; Peerapraut Wainipitapong, MD; Jirapa Champaiboon, MD; Lalita Wattanachanya, MD; Unnop Jaisamrarn, MD, MHS; Sukanya Chaikittisilpa, MD, MSc


Menopause. 2021;28(12):1351-1357. 

In This Article

Abstract and Introduction


Objective: Sarcopenia is associated with high morbidity and mortality in older women. Early detection and intervention during the postmenopausal period were hypothesized to help maintain muscle mass and performance. Although the Asian Working Group has developed guidelines for sarcopenia management, the condition has not been sufficiently investigated in the middle-aged cohort of the Asian population. This study aimed to measure the prevalence of pre-sarcopenia and sarcopenia in middle-aged postmenopausal women and to determine the factors associated with low muscle mass.

Methods: In this cross-sectional study conducted in the Menopause Clinic, King Chulalongkorn Memorial Hospital, we used the bioelectrical impedance analysis method to determine the appendicular muscle mass using a body composition analyzer (TANITA MC980 Plus). Appendicular muscle mass index, handgrip strength, and 6-m gait speed were measured in 340 women aged 45 to 65 years. Hormonal profiles, anthropometric data, and relevant history were recorded.

Results: The mean age of the study participants and time since menopause were 57.8 ± 4.5 years and 9.4 ± 5.5 years, respectively. The proportion of pre-sarcopenic, sarcopenic, and nonsarcopenic women were 11.8%, 2.7%, and 85.6%, respectively. A body mass index ≤ 20 kg/m2 had the strongest correlation with low muscle mass (odds ratio 7.1; 95% confidence interval 3.0–16.8, P < 0.001).

Conclusion: Nearly 12% of Thai middle-aged postmenopausal women were pre-sarcopenic. Early detection of symptoms of pre-sarcopenia and maintenance of a healthy body mass index may reduce the burden of this condition for middle-aged and older women.


Sarcopenia—a syndrome characterized by the gradual and generalized loss of skeletal muscle mass with progressive loss of muscle strength—increases the risk of other adverse events such as falling and causes physical disability, reduces the overall quality of life, and increases the risk of mortality.[1] The European Working Group on Sarcopenia in Older People (EWGSOP1) has defined three conceptual stages of sarcopenia.[2] Pre-sarcopenia is characterized by low muscle mass, which does not affect muscle strength or physical performance. Sarcopenia is characterized by low muscle mass and decreased muscle strength or low physical performance. Severe sarcopenia is characterized when all the criteria were met.

Studies in women found loss of muscle mass and muscle strength as they encounter menopause and aging.[3,4] Thus, muscle deterioration is likely to progress with time. The incidence of falls in older women progressively increased with the severity of sarcopenia from 15% to 72%.[5] Therefore, to reduce fall and fracture risk, it is important to prevent muscle mass loss and the consequential progression of pre-sarcopenia to sarcopenia.

As the proportion of the aged population increases, nearly one-third of older women are being diagnosed with sarcopenia, the risk factors of which are loss of weight and lower quadriceps strength.[6] An early diagnosis of pre-sarcopenia and sarcopenia in those women with recent menopause is a challenging task that would help prevent falls and fractures and promote healthy aging. Therefore, this study aimed to determine the prevalence of pre-sarcopenia and associated factors in postmenopausal women aged ≤65 years.