Prevalence, diagnosis and treatment of sarcopenic obesity in older adults: a systematic review and a meta-analysis

Objectives: Sarcopenic obesity (SO) is a syndrome increasingly recognized in older adults. We aimed to conduct a systematic review and a meta-analysis to reveal the global prevalence of SO in olders, and the effects of non-pharmacological interventions on the different components of SO. Methods: A comprehensive search of 3270 studies was conducted between 2009 and 2021 from PubMed, Scopus, and Cochrane databases. After screening we included 57 studies. Statistical analysis was performed in R software. The standardized mean difference was used as the effect size and heterogeneity was evaluated with I² statistic. Low muscle mass(MM) or low MM plus low muscle strength(MS) were used for the diagnosis of sarcopenia, body fat percentage (BF%), waist circumference (WC) or body mass index (BMI) parameters were used for the diagnosis of obesity. Intervention studies included exercise-based interventions, nutritional-based interventions,combined interventions, and electrical acupuncture. Results: The global SO prevalence was 7%. The prevalence of SO, depending on the sarcopenia definition, was 8% and 5% due to MM and MM plus MS, respectively. The prevalence of SO, depending on the definition of obesity, was 8%, 5%, and 7% according to BF%, BMI, and WC, respectively. In the overall intervention groups, BF% was reduced, MS and MM was increased. Exercise appears to have a more pronounced effect on sarcopenia. Conclusion: The global prevalence of SO in the older population was 7%. MS and MM improved, and BF% decreased significantly in the overall intervention groups, with a more pronounced effect in exercise intervention studies.