Change in handgrip strength

Handgrip strength is a validated indicator of overall muscle strength and a core diagnostic component of sarcopenia. HGS will be assessed using a calibrated hydraulic hand dynamometer. Output is recorded in kilograms (kg) of force. Higher values indicate greater muscle strength

Baseline, week4, week 8, week12, week 26.

Change in bone turnover markers

Bone turnover markers (BTMs) reflect the rate of bone remodeling, including both bone formation and bone resorption processes. These laboratory biomarkers provide insight into dynamic skeletal changes that may occur during GLP-1 receptor agonist therapy. BTMs may include: * Bone formation markers (e.g., P1NP) * Bone resorption markers (e.g., CTX) Results will be reported in standard laboratory units (e.g., ng/mL, µg/L), depending on the specific assay. Higher formation markers indicate increased bone formation; higher resorption markers indicate increased bone breakdown

Baseline, 3 month, 6 months

Change in timed up-and-go (TUG)

The Timed Up and Go (TUG) test assesses functional mobility by measuring the time required for a participant to rise from a standard chair, walk to a marked 10-foot line, turn around, return to the chair, and sit down. Time is recorded in seconds (s). * Shorter times indicate better functional mobility. * Longer times may reflect impairments in balance, gait speed, or lower-extremity strength.

Baseline, week4, week 8, week12, week 26.

Change in HbA1c

Collected via venous blood sample and analyzed using standardized laboratory assays. HbA1c will be reported as a percentage (%). Reductions in HbA1c and fasting glucose reflect improved insulin sensitivity and glycemic regulation.

Baseline, 3 month, 6 months

Change in fasting glucose

Measured after an overnight fast of at least 8 hours. Fasting glucose will be reported in mg/dL. Reductions in fasting glucose reflect improved insulin sensitivity and glycemic regulation

Baseline, 6 months

Change in weight

Measured using a calibrated digital scale with participants wearing light clothing and no shoes. Body weight will be reported in kilograms (kg). Weight change (kg) will be calculated as the difference between baseline and follow-up measurements

Baseline, week4, week 8, week12, week 26.

Change in FRAX score

Fracture risk will be evaluated using the FRAX algorithm, which integrates bone mineral density (BMD) at the femoral neck with validated clinical risk factors to estimate the 10-year probability of major osteoporotic fracture and hip fracture. FRAX results are expressed as percent probabilities (%). Lower percentages indicate reduced fracture risk.

Baseline, 6 months

Change in lipid profile

Serial lipid measurements will be collected to evaluate cardiovascular risk modification during GLP-1 receptor agonist therapy. LDL-C, HDL-C, triglycerides, and total cholesterol will be reported in mg/dL. * Change in each lipid parameter will be calculated as the difference between baseline and 6-month values. * Lower LDL-C and triglycerides, along with higher HDL-C, indicate improved cardiovascular risk profiles.

Baseline, 3 months, 6 months

Changes in exercise frequency

The Community Healthy Activities Model Program for Seniors (CHAMPS) Physical Activity Questionnaire is a validated self-report tool designed to assess weekly frequency and duration of lifestyle physical activities commonly performed by older adults. It captures a broad range of activities across light, moderate, and vigorous intensities, providing a comprehensive estimate of habitual physical activity. Responses are used to calculate the total weekly frequency of various activity categories. Weekly frequency of each activity (number of sessions per week)

Baseline, 6 months

Changes in exercise duration

The Community Healthy Activities Model Program for Seniors (CHAMPS) Physical Activity Questionnaire is a validated self-report tool designed to assess weekly frequency and duration of lifestyle physical activities commonly performed by older adults. It captures a broad range of activities across light, moderate, and vigorous intensities, providing a comprehensive estimate of habitual physical activity. Responses are used to calculate the total weekly duration of various activity categories. Higher values indicate greater physical activity engagement.

Baseline, 6 months

Change in frailty assessment

Frailty will be assessed using a questionnaire based on the Fried phenotype, evaluating five components: unintentional weight loss, exhaustion, low physical activity, slowness, and weakness. A structured data capture form modeled on the validated assessment will be used. Assessment Procedure \& Scoring: * Completed at baseline and 6 months. * Each criterion is scored as present or absent (0-5 total). * 0: Non-frail * 1-2: Pre-frail * ≥3: Frail Interpretation: Higher scores indicate greater frailty; changes over time reflect shifts in physiologic vulnerability.

Baseline, 6 months