The prevalence of sarcopenic obesity in older adults with obesity differs between the use of the chair stand test and handgrip strength as measure of altered muscle function

Rationale: Sarcopenia and obesity are prevalent conditions and often co-occur within the same individual. ESPEN and EASO reached consensus on the definition of sarcopenic obesity (SO), encompassing altered muscle function (MF) and altered body composition (BC). However, both handgrip strength (HGS) and the chair stand test (CST) have been suggested to determine MF. This study aimed to compare the prevalence of SO using HGS and CST in older adults with obesity.
Methods: Analyses were performed on the baseline data of two pooled RCT’s (MPS, PROBE) in older adults with obesity (BMI>30kg/m2 or BMI>27 with waist circumference males >102cm, females >88cm). The SO definition of ESPEN and EASO was used. Applied cutoffs for altered MF were: HGS <27kg (males), <16kg (females); CST ≥17s (males and females). Altered BC by DXA was defined as high fat mass percentage (<60y males >29%, females >41%; ≥60y males >31%, females >43%) with low appendicular lean mass percentage (males <25.7%, females <19.4%). The prevalence of SO was determined using HGS and CST and the overlap between both definitions was calculated.
Results: A total of 151 participants (age 65±6y; 59% male, BMI 33.1±4.2kg/m2) were included. Altered MF was prevalent in 5.3% (n=8) based on HGS and 14.6% (n=22) based on CST. Altered BC was prevalent in 13.9% (n=21). The prevalence of SO using HGS was 0.7% (n=1) and using CST 6.0% (n=9) with no overlap between the two definitions.
Conclusion: In older adults with obesity, there was a low prevalence of SO and the prevalence was different between the use of HGS and CST to define altered MF. The low prevalence might be explained by the absence of specific cutoffs for MF in adults with obesity. Furthermore, for the early diagnosis and prevention of SO, a continuous index for SO could be useful to identify older adults at risk of SO.