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. 2024 May 21;24(1):446.
doi: 10.1186/s12877-024-04955-w.

Sarcopenic obesity in nursing home residents: a multi-center study on diagnostic methods and their association with instrumental activities of daily living

Huiyu Tang #  1 , Runjie Li #  1 , Ruicen Li  2 , Rongna Lian  1 , Xiaoyan Chen  1 , Wenhua Jiang  1 , Jiaojiao Jiang  3 , Ming Yang  4   5
Affiliations

Sarcopenic obesity in nursing home residents: a multi-center study on diagnostic methods and their association with instrumental activities of daily living

Huiyu Tang et al. BMC Geriatr. .

Abstract

Background: Sarcopenic obesity (SO) in nursing home residents is rarely studied. We aimed to evaluate and compare the prevalence and consistency of different SO diagnostic methods and to investigate which criterion demonstrated a stronger association with instrumental activities of daily living (IADL) disability.

Methods: We consecutively recruited older adults aged ≥ 60 years, residing in 15 nursing homes in Zigong City, China. Sarcopenia obesity was defined according to the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity criteria (SOESPEN), recommending skeletal muscle mass (SMM) adjusted by body weight (SMM/W) to identify low muscle mass. Further, we adapted ESPEN criteria (SOESPEN-M) by employing SMM adjusted by body mass index (SMM/BMI).

Results: We included 832 participants (median age 73.0 years, 296 women). The prevalence of SOESPEN and SOESPEN-M was 43.5% and 45.3%, respectively. SOESPEN showed good consistency with SOESPEN-M (Cohen's kappa = 0.759). More than one-third of participants in the normal weight group were diagnosed with SOESPEN or SOESPEN-M. Even within the underweight group, the prevalence of SOESPEN and SOESPEN-M was 8.9% and 22.2%, respectively. Participants with IADL disability had significantly lower SMM/W and SMM/BMI, but higher fat mass percentage of body weight (FM%) than participants without IADL disability. After full adjustment for potential confounders, SOESPEN-M (OR 1.68, 95% CI 1.21 to 2.32), but not SOESPEN (OR 1.28, 95% CI 0.93 to 1.75), remained significantly associated with IADL disability.

Conclusions: Both SOESPEN and SOESPEN-M showed a high prevalence among nursing home residents, even among individuals with underweight or normal weight. While SOESPEN had a good consistency with SOESPEN-M, only SOESPEN-M was independently associated with IADL disability. Screening and diagnosis of SO should be conducted in nursing home residents irrespective of BMI.

Keywords: Functional assessment; Long-term care; Muscle quality; Obese sarcopenia; Physical function.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Prevalence of SOESPEN (A) and SOESPEN−M (B) stratified by age groups. Number of participants of SOESPEN (C) and SOESPEN−M (D) stratified by BMI groups. BMI, body mass index; ESPEN, European Society for Clinical Nutrition and Metabolism; SO, sarcopenic obesity. ***P ≤ 0.001; NS, no significance
Fig. 2
Fig. 2
Correlations of SMM/W (A) and SMM/BMI (B) with age among men and women and correlations of SMM with weight (C) and BMI (D) among men and women. BMI, body mass index; SMM, skeletal muscle mass
Fig. 3
Fig. 3
Group comparisons of SMM/W, SMM/BMI, and FM% stratified by sex. BMI, body mass index; FM%, fat mass percentage of body weight; IADL, instrumental activities of daily living; SMM, skeletal muscle mass
See this image and copyright information in PMC

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