Background: Sarcopenia is a muscle disease characterized by the loss of muscle mass and function, often associated with a decline in cognitive and physical performance. Individuals with chronic inflammatory diseases are more susceptible to sarcopenia, which can exacerbate the burden of the disease. However, the presence of sarcopenia and its impact on physical performance and cognitive functioning in this population remain poorly understood.

Objectives: This study aimed to investigate the presence of sarcopenia in a cohort of patients with axial spondyloarthritis (axSpA) and evaluate its impact on physical performance, cognitive functions, and quality of life.

Methods: Sarcopenia was defined using the total SARC-F score (strength, assistance while walking, rising from a chair, climbing stairs, and falls) with a cut-off value of ≥ 4 points. The Short Physical Performance Battery (SPPB) including a 4-meter-walking, chair stand, and balance tests was used to assess physical performance. Handgrip strength of the dominant extremity was also measured. Self-reported physical functioning was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI), and quality of life was assessed with the Ankylosing Spondylitis Quality of Life (ASQoL) scale. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive functioning. The risk of malnutrition was determined with the Mini Nutritional Assessment-Long Form (MNA-LF). Outcome measures were compared between patients with and without sarcopenia, and binary logistic regression was performed to identify factors associated with sarcopenia.

Results: A total of 81 patients (44.4 % males) with a mean age of 47.52 years and a mean disease duration of 8.66 years were included. Twenty-seven patients (33.3%) were diagnosed with sarcopenia based on a SARC-F score of ≥4. Sarcopenic patients exhibited significantly lower physical performance, as indicated by reduced grip strength, gait speed, chair stand, and balance test results (p≤0.001). Additionally, sarcopenic patients reported poorer quality of life (p<0.001) and worse self-reported physical functioning. Their cognitive functions were lower than non-sarcopenic people (p<0.05). Higher proportion of patients with sarcopenia were at risk of malnutrition (p=0.027). Binary logistic regression revealed that BASFI (odds ratio [OR] = 1.98, 95% CI = 1.37 – 2.85) and MoCA scores (OR = 0.84, 95 % CI = 0.71 – 0.99) were significantly associated with the presence of sarcopenia.

Conclusion: Approximately one-third of patients with axSpA in this study were diagnosed with sarcopenia, which was related to reduced physical performance. Disease-specific functional impairment, as measued by BASFI, and lower cognitive functions were independently associated with sarcopenia. These findings highlight the need for further research into the underlying mechanisms and potential interventions to address sarcopenia in this population.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.