Nutritional status, lifestyle and sarcopenia in hospitalised vs community-dwelling older adults: a comparison of two Northern Italian cohorts from the SENIOR and the Food NET projects.

Background: Sarcopenia, defined as “a progressive and generalised skeletal muscle disorder”, poses significant health challenges for older adults, increasing risks of disability, mortality, and reduced quality of life. Multiple factors, including nutritional status, physical activity, diet, and sleep quality, influence its development. Understanding the distinctive risk profiles across different populations, such as hospitalised versus community-dwelling older adults, is crucial for targeted interventions, effective prevention, and management strategies. Objectives: This thesis aims i) at comparing nutritional status, lifestyle factors (i.e., diet, physical activity, sleep), and sarcopenia prevalence between hospitalised and community-dwelling older adults, using data from the SENIOR and Food NET cohorts; ii) investigating differences in “risk profiles” (cluster) to identify setting-specific targets for sarcopenia prevention and management, ultimately supporting tailored strategies to promote healthy aging across diverse care environments. Methods: Data from the “Sustainable Eating patterN to lImit malnutritiOn in oldeR adults” (SENIOR) project and the “Food Social Sensor NETwork” (Food NET) project, encompassing 779 older adults aged ≥65 years, were used. Participants were stratified into “lifestyle clusters” based on physical activity (IPAQ-SF questionnaire for Food NET, PASE for SENIOR project), eating habits (Turconi and MEDILITE scores), and sleep quality (PSQI). Sarcopenia was assessed using the European algorithm for the definition and diagnosis of sarcopenia. Prevalence rates of sarcopenia and lifestyle patterns were investigated. Cluster analysis was used to identify “risk profiles” and logistic regression analysis was conducted to evaluate the association between lifestyle factors and sarcopenia. Results: In the Food NET cohort (community-dwelling older adults), participants were predominantly younger-old (65–74 years, 53.7%) and female (67%), whereas the SENIOR cohort (hospitalised older adults) included mostly older individuals (75–84 years, 52.1%) and males (54.5%). Obesity prevalence was markedly higher in both cohorts compared with national surveillance data, with abdominal obesity affecting over 85% of participants. Cluster analysis based on diet, physical activity, and sleep quality identified three lifestyle profiles, ranging from least to most favourable. In both cohorts, poor sleep quality was consistently reported across clusters, while significant differences were observed in physical activity and dietary habits in Food NET cohort, and in physical activity in the SENIOR cohort. Sarcopenia prevalence was 33.1% in Food NET and 17% in SENIOR, with a substantial proportion of participants classified as being “at risk” to develop sarcopenia based on low handgrip strength. In Food NET, sarcopenia prevalence did not vary across lifestyle clusters, whereas in SENIOR, the poorest lifestyle cluster exhibited the highest prevalence. Logistic regression in the hospitalised cohort further revealed that female sex was significantly associated with sarcopenia. Specifically, women showed almost twice the odds of developing sarcopenia compared to men, independent of diet, physical activity, and sleep quality. Conclusion: Sarcopenia is a multifactorial condition shaped by sex-age-related factors and modifiable lifestyle behaviours, particularly physical activity and dietary habits. Thus, these findings underscore the importance of tailored strategies for sarcopenia prevention, early identification of vulnerable subgroups and the implementation of targeted intervention for improving functional outcomes, delaying disability, and promoting healthier ageing trajectories.