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

David Scott; Fiona Blyth; Vasi Naganathan; David G Le Couteur; David J Handelsman; Louise M Waite; Vasant Hirani

doi:10.1016/j.clnu.2023.07.014

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

Clin Nutr. 2023 Sep;42(9):1610-1618. doi: 10.1016/j.clnu.2023.07.014. Epub 2023 Jul 17.

Authors

David Scott¹, Fiona Blyth², Vasi Naganathan³, David G Le Couteur⁴, David J Handelsman⁵, Louise M Waite⁶, Vasant Hirani⁷

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. Electronic address: d.scott@deakin.edu.au.
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.
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.
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.
⁵ Department of Andrology, Concord Hospital & ANZAC Research Institute, University of Sydney, New South Wales, Sydney, Australia.
⁶ Centre for Education and Research, Department of Geriatric Medicine, Concord Hospital, Sydney, New South Wales, Australia.
⁷ School of Public Health, University of Sydney, New South Wales, Sydney, Australia; The ARC Centre of Excellence in Population Ageing Research, University of Sydney, New South Wales, Sydney, Australia.

PMID: 37481869
DOI: 10.1016/j.clnu.2023.07.014

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.

Keywords: ESPEN-EASO; EWGSOP2; Falls; Physical function; Sarcopenia; Sarcopenic obesity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Consensus
Hand Strength / physiology
Humans
Obesity
Prevalence
Prospective Studies
Sarcopenia* / complications