Sarcopenic obesity and history of falls in older Italian adults: associations according to different diagnostic combinations.

Sarcopenic obesity defined using handgrip strength combined with FM% by DXA and AMM/W was associated with approximately sixfold higher odds of reporting falls in the previous year.

• Adjusted OR = 6.03 (95% CI: 1.80–20.23) for the HGS + FM% DXA + AMM/W combination
• Comparison was made against participants without SO using the same diagnostic combination
• Multivariable logistic regression models were adjusted for sex, age, education, marital status, fall-related multimorbidity, alcohol consumption, and regular physical activity
• Sample consisted of 90 older Italian adults (≥60 years) with severe obesity (BMI ≥35 kg/m²)

Sarcopenic obesity defined using handgrip strength combined with FM% by BIA and SMM/W was associated with approximately fourfold higher odds of reporting falls in the previous year.

• Adjusted OR = 3.61 (95% CI: 1.28–10.19) for the HGS + FM% BIA + SMM/W combination
• Comparison was made against participants without SO using the same diagnostic combination
• Models were adjusted for sex, age, education, marital status, fall-related multimorbidity, alcohol consumption, and regular physical activity
• The outcome was self-reported falls in the past year

Significant associations between sarcopenic obesity and falls were found only when muscle function was assessed using handgrip strength, not when assessed using the Five-Times Sit-to-Stand test.

• Four diagnostic definitions of SO were analyzed: 1) 5×STS + FM% DXA + AMM/W, 2) 5×STS + FM% BIA + SMM/W, 3) HGS + FM% DXA + AMM/W, and 4) HGS + FM% BIA + SMM/W
• Combinations using 5×STS as the muscle function assessment did not yield significant associations with falls in adjusted analyses
• This pattern held regardless of the method used to estimate FM% and muscle mass (DXA or BIA)

The study used four diagnostic combinations of sarcopenic obesity based on the 2022 ESPEN/EASO criteria, applying two muscle function tests and two body composition measurement methods.

• Muscle function was assessed using the Five-Times Sit-to-Stand (5×STS) test and handgrip strength (HGS)
• Fat mass percentage (FM%) was measured using dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA)
• Appendicular muscle mass adjusted for body weight (AMM/W) was assessed by DXA; skeletal muscle mass adjusted for body weight (SMM/W) was assessed by BIA
• SO required the concomitant presence of reduced muscle function, high fat mass, and low muscle mass adjusted for body weight

The study population consisted of 90 hospitalized older Italian adults with severe obesity recruited for a cross-sectional analysis.

• Participants were aged ≥60 years with a body mass index ≥35 kg/m²
• The study design was cross-sectional
• Participants were hospitalized older Italian adults
• The exposure variable was sarcopenic obesity and the outcome was self-reported falls in the past year