Background and Purpose: 

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.

Methods: 

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.

Results and Discussion: 

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.

Conclusions: 

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.

中文翻译：

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患有和不患有肌肉减少症的肥胖老年人的老年脆弱性：全国代表性队列研究的结果

背景和目的： 

肌肉减少性肥胖与老年人独立性丧失有关，但人们对肌肉减少性肥胖的流行病学和相关的老年人脆弱性知之甚少。因此，我们的目标是：（1）估计患有肌肉减少症的老年人的患病率，（2）检查患有或不患有肌肉减少症的肥胖老年人的老年脆弱性比率。

方法： 

1600 名具有全国代表性的 65 岁及以上社区居住的肥胖老年人样本，以及国家健康和老龄化趋势研究 (NHATS) 中记录的肌肉功能测量结果，通过性别调整握力和短期身体表现电池评分，被确定为肌肉减少症。比较患有和不患有肌肉减少症的肥胖老年人之间老年脆弱性（包括疼痛、抑郁、残疾和社会孤立）患病率的差异。

结果与讨论： 

在肥胖老年人中，18% (n = 318/1600) 患有肌肉减少症。调整年龄和性别后，肌肉减少症肥胖老年人患有 2 种或更多合并症的几率是 3.7 倍（比值比 [OR] = 3.7；95% CI 2.2-5.0），体弱的几率是 6.4 倍（OR = 6.4；95% CI 4.4-9.5）与非肌少症肥胖老年人相比。肌少症肥胖老年人也更有可能出现 1 项或多项日常生活活动障碍（OR = 3.7；95% CI 2.5-5.4）、社会孤立（OR = 2.1；95% CI 1.3-3.2）和报告活动-与非肌少症肥胖老年人相比，限制疼痛（OR = 2.0；95% CI 1.5-2.7）。这些研究结果表明，患有肌肉减少症的肥胖老年人的老年脆弱性较高，这可能会影响运动和营养干预措施的实施和结果。

结论： 

在具有全国代表性的老年人样本中，同时存在的肥胖和肌肉减少症与老年脆弱性的发生率较高有关。除了运动和饮食改变之外，可能还需要更全面的干预措施来解决这些新发现的社会和生理风险。