Sehabudin Salasa, Dhika Dharmansyah, Rohman Hikmat, Tirta Adikusuma Suparto, Ridha Wahdini, Aditya Pratama
Sarcopenia—the progressive loss of skeletal muscle mass, strength, and physical function—disproportionately affects older adults across the Asia-Pacific region, where family caregivers serve as primary providers of daily nutritional care. Cross-cultural variations in food beliefs, caregiving norms, and access to health education create a highly diverse landscape of caregiver knowledge, attitudes, and practices (KAP) that remains poorly characterised in the evidence base. This scoping review aimed to systematically map the extent, range, and nature of evidence on family caregivers’ KAP regarding sarcopenia-related nutrition for older adults across the Asia-Pacific, with explicit attention to cross-cultural variations in beliefs, practices, and structural determinants. A scoping review was conducted following the Arksey and O’Malley (2005) framework, enhanced by Levac et al. (2010), and reported per PRISMA-ScR guidelines (Tricco et al., 2018). The KAP framework was applied as an a priori organising scaffold aligned to the review’s PCC-structured objectives; themes within each domain were subsequently developed inductively through a thematic synthesis process, and domain boundaries were refined iteratively during cross-cultural comparative analysis. Systematic searches of PubMed, Scopus, and Web of Science identified 479 records; after removal of 147 duplicates and two-stage screening (Cohen’s κ = 0.886 [Cohen’s κ = 0.886]), 6 studies met inclusion criteria. Studies spanned three Asia-Pacific subregions: East Asia (n = 3), Oceania (n = 2), and Southeast Asia (n = 1). The practice domain was most frequently assessed, followed by knowledge and attitudes. Only two studies explicitly addressed sarcopenia. Thematic synthesis revealed three cross-cutting findings: (1) fragmented nutritional awareness with critical gaps in sarcopenia-specific protein knowledge; (2) culturally mediated attitudes shaped by filial piety, traditional food philosophies (e.g., Yin-Yang, Ayurveda), and structural barriers; and (3) variable dietary provision practices with a persistent disconnect between knowledge and behaviour. Subregional variation in caregiver KAP was observed across the Asia-Pacific subregions examined, with patterns suggestive of cross-cultural differences in food belief systems, structural access, and caregiving norms; however, these differences should be interpreted with caution given the limited and uneven distribution of evidence across subregions. The Asia-Pacific evidence base for family caregiver KAP in sarcopenia nutrition is nascent but growing. Given the preliminary nature of this evidence base, the findings are best understood as hypothesis-generating, identifying priority areas for primary research and intervention development. Culturally adapted, sarcopenia-specific nutrition education programmes are indicated across all subregions, particularly in Southeast Asia and South Asia where evidence remains critically sparse, pending confirmatory primary research. No studies were identified from South Asia (n = 0) or other Asia-Pacific subregions. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026.
Department of Nursing, Faculty of Sport and Health Education, Universitas Pendidikan Indonesia, Bandung, Indonesia; Doctoral Study Program in Medical Science, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia; Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
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