Phenotype of sarcopenic obesity in older individuals with a history of falling

Ya Ruth Huo; Pushpa Suriyaarachchi; Fernando Gomez; Carmen L Curcio; Derek Boersma; Piumali Gunawardene; Oddom Demontiero; Gustavo Duque

doi:10.1016/j.archger.2016.04.003

Phenotype of sarcopenic obesity in older individuals with a history of falling

Arch Gerontol Geriatr. 2016 Jul-Aug:65:255-9. doi: 10.1016/j.archger.2016.04.003. Epub 2016 Apr 20.

Authors

Ya Ruth Huo¹, Pushpa Suriyaarachchi², Fernando Gomez³, Carmen L Curcio³, Derek Boersma⁴, Piumali Gunawardene², Oddom Demontiero², Gustavo Duque⁵

Affiliations

¹ Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia; Sydney Medical School Nepean, The University of Sydney, Penrith, NSW 2750, Australia.
² Sydney Medical School Nepean, The University of Sydney, Penrith, NSW 2750, Australia; Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW 2750, Australia.
³ Sydney Medical School Nepean, The University of Sydney, Penrith, NSW 2750, Australia; Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW 2750, Australia; Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, International Association of Gerontology and Geriatrics Collaborative Centre, University of Caldas, Manizales, Colombia.
⁴ Department of Geriatric Medicine, Nepean Hospital, Penrith, NSW 2750, Australia.
⁵ Sydney Medical School Nepean, The University of Sydney, Penrith, NSW 2750, Australia; Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, VIC 3021, Australia; Department of Medicine, Melbourne Clinical School - Western Campus, St. Albans, VIC 3021 Australia. Electronic address: gustavo.duque@unimelb.edu.au.

PMID: 27131229
DOI: 10.1016/j.archger.2016.04.003

Abstract

Background: Although sarcopenic obesity is associated with disability in middle-aged community-dwelling individuals, the phenotype of sarcopenic obesity in people 65 and older, especially those with a history of falls, remain unknown. To fill this knowledge gap, the goal of this study was to obtain a comprehensive phenotype of sarcopenic obesity in this high-risk population.

Methods: Cross-sectional study of 680 subjects (mean age=79±9, 65% female) assessed between 2009 and 2013 at the Falls and Fractures Clinic, Nepean Hospital (Penrith, Australia). The assessment included a comprehensive examination, posturography, gait velocity, grip strength, bone densitometry and body composition by DXA, and blood tests for biochemical status. Patients were divided into four groups based on DXA and clinical criteria: 1) sarcopenic obese; 2) non-sarcopenic obese; 3) sarcopenic and; 4) non-sarcopenic/non-obese. The difference between groups was assessed by one-way ANOVA, chi-square analysis, and multivariable linear regression.

Results: Sarcopenic obese subjects were older (81.1±7.3), mostly female and more likely to have lower bone mineral density, lower grip strength, slower gait velocity, and poor balance. Sarcopenic obese individuals also showed significantly higher parathyroid hormone and lower vitamin D.

Conclusions: We identified a particular set of clinical and biochemical characteristics in our subgroup of sarcopenic obese older fallers. Identification of these particular characteristics in the clinical setting is essential in order to prevent poor outcomes in this high-risk population.

Keywords: Falls; Obesity; Osteopenia; Osteosarcopenia; Sarcopenia; Sarcopenic obesity.

MeSH terms

Absorptiometry, Photon
Accidental Falls*
Age Factors
Aged
Aged, 80 and over
Australia / epidemiology
Bone Density / physiology
Cross-Sectional Studies
Female
Gait / physiology
Hand Strength / physiology
Humans
Male
Obesity / epidemiology*
Obesity / physiopathology*
Parathyroid Hormone / blood
Postural Balance / physiology
Risk Factors
Sarcopenia / epidemiology*
Sarcopenia / physiopathology*
Sex Factors
Vitamin D / blood

Substances

Parathyroid Hormone
Vitamin D