Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore.
Department of Kinesiology, Towson University, Towson, Maryland.
J Geriatr Phys Ther. 2022;46(3):168-173. doi: 10.1519/JPT.0000000000000358. Epub 2022 Aug 18.
Sarcopenic obesity is associated with loss of independence among older adults, but the epidemiology of sarcopenic obesity and associated geriatric vulnerabilities are poorly understood. Thus, our objectives were to: (1) estimate the prevalence of older adults with sarcopenic obesity and (2) examine rates of geriatric vulnerabilities among obese older adults, with and without sarcopenia.
A nationally representative sample of 1600 community-dwelling older adults 65 years and older with obesity and documented measures of muscle function from the National Health and Aging Trends Study (NHATS) was identified as sarcopenic using sex-adjusted grip strength and Short Physical Performance Battery scores. Differences in the prevalence of geriatric vulnerabilities (including pain, depression, disability, and social isolation) were compared between obese older adults with and without sarcopenia.
Among obese older adults, 18% (n = 318/1600) were sarcopenic. After adjusting for age and sex, sarcopenic obese older adults had 3.7 times the odds of having 2 or more comorbid conditions (odds ratio [OR] = 3.7; 95% CI 2.2-5.0) and 6.4 times the odds of being frail (OR = 6.4; 95% CI 4.4-9.5) as compared with nonsarcopenic obese older adults. Sarcopenic obese older adults were also more likely to have 1 or more activities of daily living disabilities (OR = 3.7; 95% CI 2.5-5.4), be socially isolated (OR = 2.1; 95% CI 1.3-3.2), and report activity-limiting pain (OR = 2.0; 95% CI 1.5-2.7) as compared with nonsarcopenic obese older adults. These findings, in a nationally representative cohort, suggest obese older adults who are sarcopenic have higher rates of geriatric vulnerabilities that could impact delivery and outcomes of exercise and nutrition interventions.
Concomitant obesity and sarcopenia are associated with higher rates of geriatric vulnerabilities among a nationally representative sample of older adults. More comprehensive interventions, beyond exercise and diet modifications, may be necessary to additionally address these newly identified social and physiological risks.
肌少症性肥胖与老年人丧失独立性有关，但肌少症性肥胖的流行病学和相关老年脆弱性仍知之甚少。因此，我们的目标是：（1）估计患有肌少症性肥胖的老年人的患病率；（2）检查肥胖老年人中有无肌少症的情况下，老年脆弱性的发生率。
从国家健康老龄化趋势研究（NHATS）中确定了一个具有代表性的 1600 名 65 岁及以上、患有肥胖症且肌肉功能有记录的社区居住的老年人样本，这些老年人使用性别调整后的握力和短体物理性能电池评分来确定是否患有肌少症。比较了肥胖老年人中有无肌少症的情况下，老年脆弱性（包括疼痛、抑郁、残疾和社会隔离）的患病率差异。
在肥胖的老年人中，18%（n=318/1600）患有肌少症性肥胖。在调整年龄和性别后，与非肌少症性肥胖的老年人相比，肌少症性肥胖的老年人有 3.7 倍的可能性患有 2 种或更多种合并症（比值比[OR]=3.7；95%置信区间[CI]2.2-5.0），有 6.4 倍的可能性患有衰弱（OR=6.4；95%CI 4.4-9.5）。与非肌少症性肥胖的老年人相比，肌少症性肥胖的老年人也更有可能有 1 种或多种日常生活活动残疾（OR=3.7；95%CI 2.5-5.4）、社会隔离（OR=2.1；95%CI 1.3-3.2）和报告活动受限的疼痛（OR=2.0；95%CI 1.5-2.7）。这些发现来自一个具有全国代表性的队列，表明肥胖的老年人如果同时患有肌少症，其老年脆弱性的发生率更高，这可能会影响运动和营养干预的实施和结果。
在一个具有全国代表性的老年人样本中，肥胖症和肌少症同时存在与更高的老年脆弱性发生率相关。可能需要更全面的干预措施，超出运动和饮食的改变，以进一步解决这些新确定的社会和生理风险。
