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Sarcopenia prevalence and functional outcomes in older men with obesity: Comparing the use of the EWGSOP2 sarcopenia versus ESPEN-EASO sarcopenic obesity consensus definitions.

Author information

Affiliations

  • 1. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
      Authors
    • Scott D 1
    (1 author)
  • 2. School of Public Health, University of Sydney, New South Wales, Sydney, Australia; Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia.
      Authors
    • Blyth F 2
    (1 author)
  • 3. Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; Concord Clinical School, Faculty of Medicine and Health, University of Sydney, New South Wales, Sydney, Australia.
      Authors
    • Naganathan V 3
    (1 author)
  • 4. Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia; ANZAC Research Institute & Charles Perkins Centre, University of Sydney, New South Wales, Sydney, Australia.
      Authors
    • Le Couteur DG 4
    (1 author)
  • 5. Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia.
      Authors
    • Handelsman DJ 5
    (1 author)
    • Show all (7)

ORCIDs linked to this article

Clinical Nutrition (Edinburgh, Scotland), 17 Jul 2023, 42(9):1610-1618
https://doi.org/10.1016/j.clnu.2023.07.014 PMID: 37481869 

Abstract 

Background & aims

The potential for older adults with obesity to also have sarcopenia, and the health consequences of 'sarcopenic obesity', may be underappreciated by health professionals. The primary aim of this secondary analysis of a prospective cohort study of older men was to explore the prevalence and functional outcomes of sarcopenic obesity based on different consensus definitions.

Methods

1416 community-dwelling men aged ≥70 years were classified into sarcopenia categories according to the European Working Group on Sarcopenia in Older People (EWGSOP2) definition, and sarcopenic obesity categories according to the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity (ESPEN-EASO) definition. Descriptive analyses determined prevalence of sarcopenia in obese and non-obese older men. Multivariable analyses compared associations with functional outcomes including activity of daily living (ADL) and instrumental activity of daily living (IADL) disability and 12-month incident falls.

Results

According to the EWGSOP2 definition, 12.6% of men had confirmed sarcopenia but only 0.3% of men had sarcopenia and obesity (BMI ≥30 kg/m2). Conversely, 9.6% of men had sarcopenic obesity according to the ESPEN-EASO definition. Notably, no men with a BMI ≥32 kg/m2 were classified as having EWGSOP2-confirmed sarcopenia, despite the fact that 60.8% of all men with BMI ≥32 kg/m2 had low muscle strength. Due to low numbers (N = 4) of obese older men with EWGSOP2-confirmed sarcopenia, associations with functional outcomes were not assessed. Men with sarcopenic obesity according to the ESPEN-EASO definition had significantly lower hand grip strength, higher chair-stands time and slower gait speed (all P < 0.05), increased odds for ADL (odds ratio: 5.02, 95% CI: 1.85-13.58) and IADL (2.18, 1.38-3.45) disability, and higher 12-month incident falls rates (incident rate ratio: 1.59, 95% CI: 1.03-2.44) than men with neither sarcopenia nor obesity.

Conclusion

Low muscle strength is common in older men with obesity, but the prevalence of sarcopenia is likely to be underestimated when the EWGSOP2 operational definition is applied in this population. The ESPEN-EASO operational definition of sarcopenic obesity appears to provide a valid approach for identifying older men with obesity who are at risk of poor functional outcomes related to sarcopenia.

Full text links 

Read article at publisher's site: https://doi.org/10.1016/j.clnu.2023.07.014

Read article for free, from open access legal sources, via Unpaywall: http://www.clinicalnutritionjournal.com/article/S0261561423002418/pdfUnpaywall

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Funding 

Funders who supported this work.

National Health and Medical Research Council (2)