Sarcopenic obesity and falls in older adults: A validation study of ESPEN/EASO criteria and modifications in Western China communities

Abstract

Objectives

The ESPEN and the EASO recently developed consensus criteria for sarcopenic obesity (SO), employing the skeletal muscle mass to weight (SMM/W) ratio. Emerging evidence suggests that adjusting skeletal muscle mass for body mass index (SMM/BMI) could enhance the predictive accuracy for health outcomes. We aimed to validate the ESPEN/EASO criteria and explore the potential benefits of the SMM/BMI adjustment in predicting falls among older adults in Western China.

Methods

We conducted a multicenter, cross-sectional study and included community-dwelling older adults. The diagnosis of SO was determined using the standard ESPEN/EASO consensus criteria (SO_ESPEN) and a modified version adjusting SMM/BMI (SO_ESPEN-M). The associations of SO_ESPEN, SO_ESPEN-M, and their components with falls were analyzed.

Results

Among the 1353 participants, the prevalence of SO was 13.2 % (SO_ESPEN) and 11.4 % (SO_ESPEN-M), which increased with age and higher BMI levels. Within participants with a normal BMI, 4.2 % and 6.2 % were found to have SO_ESPEN and SO_ESPEN-M, respectively. SMM/W and SMM/BMI negatively correlated with fall risk (p=0.042 and p=0.021, respectively). Upon adjusting for confounders, only SO_ESPEN was significantly associated with falls (odds ratios [OR] 1.61, 95 % confidence interval [CI] 1.08 to 2.40), whereas the association for SO_ESPEN-M did not achieve significance (OR 1.55, 95 % CI 0.99 to 2.43).

Conclusions

This research validated the ESPEN/EASO criteria (SO_ESPEN) and their modified version (SO_ESPEN-M) among community-dwelling older adults in Western China. The SMM/BMI adjustment appears to offer a lower estimate of SO prevalence, with only SO_ESPEN showing a significant association with falls.