Risk factors associated with sarcopenic obesity in older adults: A meta-analysis and systematic review

Sarcopenic obesity is an important health and wellness issue in older adults and is strongly associated with poor outcomes. This meta-analysis aimed to summarize risk factors for sarcopenic obesity in older adults and to observe differences between subgroups.

We conducted a comprehensive search of PubMed, Embase, Web of Science, Cochrane Library, and CINAHL databases to identify articles on risk factors for sarcopenic obesity in older adults. The search was conducted from the date of the library until April 20, 2025, and the language restriction was English. Stata 17.0 software was used for random effect meta-analyses, subgroup analyses, meta-regression, sensitivity analyses, and Egger's test.

A total of 37 studies were included, including 6 cohort studies and 31 cross-sectional studies, with a total sample size of 90,786 older adults. The results showed that the risk factors for sarcopenic obesity in older adults included, respectively, age, education level (high school and above), and marital status (married) among the general demographic factors; regular exercise, physical inactivity, and sedentary time among the behavioral factors; diabetes, hypertension, osteoporosis, depression, mild cognitive impairment, a fall history, frailty, and metabolic syndrome among the disease factors; hyperlipidaemia, high triglycerides and low high-density lipoprotein cholesterol among the blood lipid factors; and 25 (OH) D among the nutritional intake factors.

Our study provides validated evidence for identifying risk factors for sarcopenic obesity in older adults and provides targeted strategies for the development of preventive and therapeutic measures.