Sarcopenia in Older Adults: Prevalence, Risk Factors, International Experience in Healthcare Organization, and Regulatory and Legal Frameworks in Kazakhstan—A Literature Review
Ayagul Sayasatovna Zhubaniyazova, Gulmira Arystangalievna Umarova, Gulnara Arystangalievna Batyrova, Artashes Eduardovich Tadevosyan
A
BSTRACT
Introduction:
Sarcopenia is a progressive skeletal muscle disorder associated with falls, disability, hospitalization, and death. Reported prevalence ranges from below 5% to above 70%, a spread that obstructs clinical interpretation and health policy.
Aims:
To determine what drives this divergence; to synthesise risk factors; to review international experience in organizing care and to appraise Kazakhstan’s regulatory framework against the sarcopenia care pathway.
Methods:
Structured narrative review reported according to Scale for the Assessment of Narrative Review Articles (SANRA). PubMed/MEDLINE, Scopus, and Web of Science Core Collection were searched for 2015–2025 (20,960 records). Inclusion required an explicitly stated diagnostic definition for any prevalence estimate. Prevalence was stratified by diagnostic criterion, care setting, and age. Quality was appraised with Joanna Briggs Institute (JBI), A MeaSurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), and SANRA. Kazakhstani regulatory acts were retrieved from adilet.zan.kz.
Results:
The divergence is largely an artifact of measurement. Where Asian and European definitions were applied to the same 644 participants in Tehran, prevalence changed from 16.5% to 32.5%. A Chinese systematic review likewise found substantial variation across subgroups assessed with different criteria, although those subgroup estimates were derived from different sets of studies. The measurement method had an independent effect (16.5%–16.9% by bioelectrical impedance analysis or dual-energy X-ray absorptiometry versus 26.9% by anthropometry). After stratification, the estimates converged: 10%–17% in the community, 20%–35% in hospital, and 25%–50% in long-term care. Resistance exercise with adequate protein intake is the only intervention with consistent supporting evidence; no pharmacological agent is currently approved specifically for sarcopenia by major regulatory authorities. In Kazakhstan, the infrastructure for sarcopenia care exists in law, yet sarcopenia is named in no regulatory act, and no national prevalence data exist.
Conclusions:
A prevalence figure is uninterpretable unless the diagnostic criterion, the measurement method, and the care setting are stated together. For Kazakhstan, the reform required is not a new framework but the insertion of sarcopenia into the existing one.