Abstract / Summary
Abstract Background/Objectives Sarcopenic obesity (SO) is associated with adverse outcomes. This study aimed to assess the prevalence of SO diagnosed using the ESPEN-EASO approach and its correlations with functional impairment in an acute geriatric setting. Subjects/Methods Observational study including 453 older adults admitted to a Geriatric Unit. According to the ESPEN-EASO approach, patients were screened for obesity (BMI), assessed for handgrip strength (HGS, dynamometry), and body composition (bioimpedance analysis). SO was defined by low HGS, reduced relative to body weight skeletal muscle mass (SMM%), and increased relative fat mass (FM%). Screen-positive patients not meeting SO criteria were classified as obese (OB). Screen-negative patients with low SMM% and HGS were defined as sarcopenic (SARC); the remaining served as control (NS-NO). Functional status was investigated by IADL and by basal ADL collected at admission, during hospitalization, and at discharge and analyzed using trajectory modeling and univariate and multivariate adjusted models. Results Among enrolled patients (mean age: 84.9 ± 7.0 y, F: 236, 52.1%), 36 (7.9%) had SO, 65 (14.3%) OB, 98 (21.0%) SARC, and 254 (56.7%) NS-NO. In multivariate analyses (NS-NO as reference) only SO demonstrated an increased risk of impaired ADL at discharge while OB and SARC did not. Trajectory modeling confirmed an SO-specific association with functional impairment followed by lower ADL recovery. Age, malnutrition, and cognitive impairment were independently associated with reduced ADL at admission and at discharge and with IADL. Conclusions Sarcopenic obesity is associated with a higher risk of poor ADL at discharge, emphasizing the importance of personalized obesity phenotyping in hospitalized older adults.