Sarcopenic Obesity in Older Adults: A More Dependent, Frail, and Even Fatal Condition than Sarcopenia or Obesity Alone. A Retrospective Cross-Sectional Study

Background: Sarcopenia, characterized by age-related declines in muscle mass and strength, and obesity, marked by excessive body fat accumulation, often manifest concurrently, leading to a new entity known as sarcopenic obesity (SO). Although there are many studies on SO in older adults, the number of studies with new definition criteria is limited. Methods: We conducted a cross-sectional retrospective study including 364 patients aged 65 and older who underwent Bioelectrical Impedance Analysis (BIA) to assess body composition. We applied geriatric assessments (Katz Index of Activities of Daily Living, Lawton Instrumental Activities of Daily Living Scale), mini nutritional assessment, geriatric depression scale, and mental status examination). SO was defined using ESPEN (European Society for Clinical Nutrition and Metabolism) and EASO (European Association for the Study of Obesity) criteria, and frailty was graded with the clinical frailty score. Mortality data were obtained. We analyzed the associations of SO with geriatric tests, frailty, and mortality using univariate and multivariate analyses. Results: The mean age of the participants was 77.11 years (SD: 6.97). The prevalence rates for the groups were as follows: 39.6% classified as normal, 16.5% as obese (O), 19.5% as sarcopenic (S), and 24.5% as sarcopenic obese (SO). Patients in the SO group demonstrated significantly lower scores in functional and cognitive assessments, including ADL, IADL, MMSE, and MNA (p-values: 0.002, <0.001, <0.001, and <0.001, respectively). Additionally, this group exhibited reduced handgrip strength and elevated mortality rates (p = 0.002). SO patients showed the highest rates of cognitive impairment, S patients had the most elevated depression scores, and O patients displayed the slowest walking speeds. Both hypertension (β = 0.396, p = 0.001) and diabetes mellitus (β = 3.074, p < 0.001) were identified as significant risk factors for SO, with diabetes increasing the risk approximately threefold. Conclusion: SO exhibited greater physical dependence, mortality, and frailty. The S group showed a higher tendency toward depression. Significant risk factors for SO included poor nutrition, cognitive decline, low muscle strength, hypertension, and diabetes.