Prevalence of sarcopenic obesity in the older non-hospitalized population: a systematic review and meta-analysis

Abstract

Abstract Background Sarcopenic obesity emerges as a risk factor for adverse clinical outcomes in non-hospitalized older adults, including physical disabilities, metabolic diseases, and even mortality. In this systematic review and meta-analysis, we investigated the overall SO prevalence in non-hospitalized adults aged ≥ 65 years and assessed the sociodemographic, clinicobiological, and lifestyle factors related to SO. Methods We searched the PubMed, Embase, Cochrane Library, and Web of Science databases for studies reporting the prevalence of SO from database inception to October 2023. Two researchers independently screened the literature, evaluated the study quality, and extracted the data. Both fixed- and random-effects models were used in the meta-analysis to estimate the pooled SO prevalence and perform subgroup analyses. Publication and sensitivity bias analyses were performed to test the robustness of the associations. Results Among 46 studies eligible for review and a total of 71,757 non-hospitalized older adults, the combined prevalence of SO was 14% (95% CI:11–17%, I2 = 99.5%, P < 0.01). Subgroup analysis according to lifestyle factors demonstrated that the SO prevalence was 17% (95% CI: 8–29%, I2 = 99.5%, P < 0.01) in older adults without exercise habits. Regarding clinicobiological factors, older adults with a history of falls (15% [95% CI: 10–22%, I2 = 82%, P < 0.01]), two or more chronic diseases (19% [95% CI: 10–29%, I2 = 97%, P < 0.01]), functional impairment (33% [95% CI: 29–37%, I2 = 0%, P = 0.95]), cognitive impairment (35% [95% CI: 9–65%, I2 = 83%, P = 0.02]), osteoporosis (20% [95% CI: 8–35%, I2 = 96%, P < 0.01]), high fasting glucose level (17% [95% CI: 1–49%, I2 = 98%, P < 0.01]), or the use of antipsychotics (13% [95% CI: 2–28%, I2 = 0%, P = 0.32]) exhibited a higher SO prevalence. Conclusion SO prevalence is high among non-hospitalized older adults, especially those with functional and cognitive impairments. Thus, SO is a potential problem for the aging population; implementation of planned interventions in the community is needed to reduce the prevalence and adverse outcomes of SO.