The impact of sarcopenia and obesity on mortality of older adults: five years results

Gulru Ulugerger Avci; Bahar Bektan Kanat; Gunay Can; Veysel Suzan; Damla Unal; Pelin Degirmenci; Suna Avci; Hakan Yavuzer; Deniz Suna Erdincler; Alper Doventas

doi:10.1007/s11845-023-03392-9

The impact of sarcopenia and obesity on mortality of older adults: five years results

Ir J Med Sci. 2023 Oct;192(5):2209-2216. doi: 10.1007/s11845-023-03392-9. Epub 2023 May 19.

Affiliations

¹ Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey. gulru83@gmail.com.
² Division of Geriatric Medicine, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
³ Department of Public Health, Cerrahpasa Medical Faculty, İstanbul University-Cerrahpaşa, Istanbul, Turkey.

PMID: 37202585
DOI: 10.1007/s11845-023-03392-9

Abstract

Aim: Sarcopenia and obesity can cause severe physical and metabolic complications. We aimed to investigate the risk of mortality associated with sarcopenia and obesity in older adults.

Method: We designed a retrospective, observational cohort study showing the 5-year mortality of older patients in a tertiary geriatric outpatient clinic. Sociodemographic characteristics, medical history, anthropometric measurements, medications, and comorbidities were recorded. Sarcopenia was evaluated with skeletal muscle mass, handgrip strength, and gait speed. We defined sarcopenic obesity as sarcopenia plus obesity (as a body mass index ≥ 30 kg/m2). We classified the participants into four groups according to whether they were sarcopenic and/or obese: non-sarcopenic non-obese, non-sarcopenic obese, sarcopenic non-obese, and sarcopenic obese. The final overall survival of the patients was obtained from the hospital data system.

Results: Of the 175 patients, the mean age was 76.1 ± 6.4, and the majority were female (n = 120). Sixty-eight had sarcopenia (39%). The prevalence of obesity was 27%. Thirty-eight patients had died within five years (22%). The mortality rate was significantly higher in the oldest (age 85 and above) and sarcopenic groups (p < 0.001, 0.004, respectively). The mortality rate was highest in the sarcopenic obese group (40.9%). Age (HR: 1.13, 95% CI: 1.07-1.19, p: < 0.001), sarcopenic obesity (HR: 4.85, 95% CI: 1.91-12.31, p: 0.001), sarcopenia (HR: 2.26, 95% CI: 1.15-4.43, p: 0.018) and obesity (HR: 2.15, 95% CI: 1.11-4.17, p: 0.023) were independently associated with mortality at 5 years. The Kaplan-Meier analysis and Log-Rank test showed that sarcopenic obese patients had the highest cumulative mortality incidence rates.

Conclusion: Sarcopenic-obese participants had the highest mortality incidence compared to those without obesity or sarcopenia. In addition, the presence of sarcopenia or obesity alone also had a significant role in mortality risk. So, we should especially focus on maintaining or increasing muscle mass and preventing obesity.

Keywords: Mortality; Obesity; Older Age; Sarcopenia; Sarcopenic Obesity.