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Abstract
Sarcopenic obesity is a geriatric syndrome characterized by the coexistence of excess adipose tissue and a decrease in muscle mass and function. This condition is associated with changes in body composition, functional decline, frailty, and an increased risk of falls, constituting a significant public health problem among older adults, especially in rural communities. To evaluate the impact of sarcopenic obesity on body composition, functional performance, and fall risk in older adults living in rural communities in Ecuador. A cross-sectional observational study of 316 older adults (?65 years) living in rural communities in Ecuador. Participants were classified, according to the ESPEN/EASO criteria, into the following groups: sarcopenic obesity, non-obese sarcopenia, obese non-sarcopenia, and non-obese non-sarcopenia. Body composition was assessed using electrical bioimpedance analysis; handgrip strength, walking speed, and fall risk were assessed using the Tinetti Test. Statistical analysis included one-way ANOVA and post hoc tests (p < 0.05). The prevalence of sarcopenic obesity was 2.5% (n=8). This group had the highest percentage of body fat (50.59±9.59%), the lowest skeletal muscle mass (13.06±4.79 kg), and a significantly reduced basal metabolic rate (940 kcal/day). Functional dependence was higher in the groups with non-obese sarcopenia and non-sarcopenic obesity (p=.043). Thirty-seven point five percent of the group with sarcopenic obesity had a high risk of falling, compared with 21% of the non-sarcopenic, non-obese group (p=.095). Sarcopenic obesity is associated with an unfavorable body composition and greater functional impairment in older adults in rural communities in Ecuador. The assessment of body composition, as a complement to body mass index, may facilitate early detection and guide interventions to preserve functionality and promote healthy aging.
References
Brubaker, P. H., Nicklas, B. J., Houston, D. K., Hundley, W. G., Chen, H., Molina, A. J. A., Lyles, W. M., Nelson, B., Upadhya, B., Newland, R., & Kitzman, D. W. (2023). A randomized, controlled trial of resistance training added to caloric restriction plus aerobic exercise training in obese heart failure with preserved ejection fraction. Circulation: Heart Failure, 16(2). https://doi.org/10.1161/CIRCHEARTFAILURE.122.010161
Cataltepe, E., Ceker, E., Fadiloglu, A., Gungor, F., Karakurt, N., & Varan, H. D. (2025). The prevalence and related factors of social frailty in older adults: A low- and middle-income country perspective. Australasian Journal on Ageing, 44(1). https://doi.org/10.1111/ajag.13409
Colleluori, G., & Villareal, D. T. (2021). Aging, obesity, sarcopenia and the effect of diet and exercise intervention. Experimental Gerontology, 155. https://doi.org/10.1016/j.exger.2021.111561
Daskalopoulou, C., Wu, Y.-T., Pan, W., Giné Vázquez, I., Prince, M., Prina, M., & Tyrovolas, S. (2020). Factors related with sarcopenia and sarcopenic obesity among low- and middle-income settings: The 10/66 DRG study. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-76575-4
Del Brutto, O. H., Mera, R. M., Sedler, M. J., Rumbea, D. A., Arias, E. E., Gutierrez, J., & Del Brutto, V. J. (2025). Physical versus cognitive impairment in stroke-free older adults living in rural settings: Relative contributions to decreased functionality. International Journal of Geriatric Psychiatry, 40(11). https://doi.org/10.1002/gps.70173
Donini, L. M., Busetto, L., Bischoff, S. C., Cederholm, T., Ballesteros-Pomar, M. D., Batsis, J. A., Bauer, J. M., Boirie, Y., Cruz-Jentoft, A. J., Dicker, D., Frara, S., Frühbeck, G., Genton, L., Gepner, Y., Giustina, A., Gonzalez, M. C., Han, H.-S., Heymsfield, S. B., Higashiguchi, T., … & Barazzoni, R. (2022). Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Obesity Facts, 15(3), 321–335. https://doi.org/10.1159/000521241
Fien, S., Linton, C., Mitchell, J. S., Wadsworth, D. P., Szabo, H., Askew, C. D., & Schaumberg, M. A. (2022). Characteristics of community-based exercise programs for community-dwelling older adults in rural/regional areas: A scoping review. Aging Clinical and Experimental Research, 34(7), 1511–1528. https://doi.org/10.1007/s40520-022-02079-y
Fornelli, C., Sofia Cento, A., Nevi, L., Mastrocola, R., Ferreira Alves, G., Caretti, G., Collino, M., & Penna, F. (2025). The BET inhibitor JQ1 targets fat metabolism and counteracts obesity. Journal of Advanced Research, 68, 403–413. https://doi.org/10.1016/j.jare.2024.02.001
Gao, Q., Hu, K., Yan, C., Zhao, B., Mei, F., Chen, F., Zhao, L., Shang, Y., Ma, Y., & Ma, B. (2021). Associated factors of sarcopenia in community-dwelling older adults: A systematic review and meta-analysis. Nutrients, 13(12). https://doi.org/10.3390/nu13124291
Gualan, M., Ster, I. C., Veloz, T., Granadillo, E., Llangari-Arizo, L. M., Rodriguez, A., Critchley, J. A., Whincup, P., Martin, M., Romero-Sandoval, N., & Cooper, P. J. (2024). Cardiometabolic diseases and associated risk factors in transitional rural communities in tropical coastal Ecuador. PLOS ONE, 19(7). https://doi.org/10.1371/journal.pone.0307403
Hyvärinen, M., Kankaanpää, A., Rantalainen, T., Rantanen, T., Laakkonen, E. K., & Karavirta, L. (2025). Body composition and functional capacity as determinants of physical activity in middle-aged and older adults: A cross-sectional analysis. European Review of Aging and Physical Activity, 22(1). https://doi.org/10.1186/s11556-025-00372-z
Jacob, L., Kostev, K., Smith, L., Oh, H., López-Sánchez, G. F., Shin, J. I., Abduljabbar, A. S., Haro, J. M., & Koyanagi, A. (2021). Sarcopenia and mild cognitive impairment in older adults from six low- and middle-income countries. Journal of Alzheimer’s Disease, 82(4), 1745–1754. https://doi.org/10.3233/JAD-210321
Ji, T., Li, Y., & Ma, L. (2022). Sarcopenic obesity: An emerging public health problem. Aging and Disease, 13(2), 379–388. https://doi.org/10.14336/AD.2021.1006
Kim, S., & Won, C. W. (2022). Sex-different changes of body composition in aging: A systemic review. Archives of Gerontology and Geriatrics, 102. https://doi.org/10.1016/j.archger.2022.104711
Kosiborod, M. N., Abildstrøm, S. Z., Borlaug, B. A., Butler, J., Rasmussen, S., Davies, M., Hovingh, G. K., Kitzman, D. W., Lindegaard, M. L., Møller, D. V., Shah, S. J., Treppendahl, M. B., Verma, S., Abhayaratna, W., Ahmed, F. Z., Chopra, V., Ezekowitz, J., Fu, M., Ito, H., … & STEP-HFpEF Trial Committees and Investigators. (2023). Semaglutide in patients with heart failure with preserved ejection fraction and obesity. The New England Journal of Medicine, 389(12), 1069–1084. https://doi.org/10.1056/NEJMoa2306963
Li, C.-W., Yu, K., Shyh-Chang, N., Jiang, Z., Liu, T., Ma, S., Luo, L., Guang, L., Liang, K., Ma, W., Miao, H., Cao, W., Liu, R., Jiang, L.-J., Yu, S.-L., Li, C., Liu, H.-J., Xu, L.-Y., Liu, R.-J., … & Liu, G.-S. (2022). Pathogenesis of sarcopenia and the relationship with fat mass: Descriptive review. Journal of Cachexia, Sarcopenia and Muscle, 13(2), 781–794. https://doi.org/10.1002/jcsm.12901
Liu, C., Wong, P. Y., Chung, Y. L., Chow, S. K.-H., Cheung, W. H., Law, S. W., Chan, J. C. N., & Wong, R. M. Y. (2023). Deciphering the “obesity paradox” in the elderly: A systematic review and meta-analysis of sarcopenic obesity. Obesity Reviews, 24(2). https://doi.org/10.1111/obr.13534
Luo, Y., Wang, Y., Tang, S., Xu, L., Zhao, X., Han, M., Liu, Y., Xu, Y., & Han, B. (2024). Prevalence of sarcopenic obesity in the older non-hospitalized population: A systematic review and meta-analysis. BMC Geriatrics, 24(1). https://doi.org/10.1186/s12877-024-04952-z
Maheshwari, V., & Basu, S. (2023). Sarcopenic obesity burden, determinants, and association with risk of frailty, falls, and functional impairment in older adults with diabetes: A propensity score matching analysis. Cureus, 15(11). https://doi.org/10.7759/cureus.49601
Mirzai, S., Carbone, S., Batsis, J. A., Kritchevsky, S. B., Kitzman, D. W., & Shapiro, M. D. (2024). Sarcopenic obesity and cardiovascular disease: An overlooked but high-risk syndrome. Current Obesity Reports, 13(3), 532–544. https://doi.org/10.1007/s13679-024-00571-2
Paranhos Amorim, D. N., Nascimento, D. da C., Stone, W., Alves, V. P., & Coelho Vilaça & Silva, K. H. (2022). Body composition and functional performance of older adults. Osteoporosis and Sarcopenia, 8(2), 86–91. https://doi.org/10.1016/j.afos.2022.04.002
Prado, C. M., Batsis, J. A., Donini, L. M., Gonzalez, M. C., & Siervo, M. (2024). Sarcopenic obesity in older adults: A clinical overview. Nature Reviews Endocrinology, 20(5), 261–277. https://doi.org/10.1038/s41574-023-00943-z
Simati, S., Kokkinos, A., Dalamaga, M., & Argyrakopoulou, G. (2023). Obesity paradox: Fact or fiction? Current Obesity Reports, 12(2), 75–85. https://doi.org/10.1007/s13679-023-00497-1
Smith, L., Shin, J. I., López Sánchez, G. F., Schuch, F., Tully, M., Barnett, Y., Butler, L., Pizzol, D., Veronese, N., Soysal, P., Kostev, K., Jacob, L., & Koyanagi, A. (2023). Physical multimorbidity and sarcopenia among adults aged ?65 years in low- and middle-income countries. Gerontology, 69(4), 406–415. https://doi.org/10.1159/000527341
Yang, M., Hu, M., Zhang, Y., Jia, S., Sun, X., Zhao, W., Ge, M., & Dong, B. (2022). Sarcopenic obesity is associated with frailty among community-dwelling older adults: Findings from the WCHAT study. BMC Geriatrics, 22(1). https://doi.org/10.1186/s12877-022-03617-z
Yin, S., Su, J., Bao, J., Yu, H., Liu, M., & Ji, X. (2025). Sarcopenic obesity and risk of falls: Findings in middle-aged and older Chinese population from CHARLS. Aging Clinical and Experimental Research, 37(1). https://doi.org/10.1007/s40520-025-03215-0
Yu, C., Meng, Z., Wang, X., & Xiao, J. (2025). Associations between sarcopenic obesity and risk of falls: A population-based cohort study among middle-aged and older adults using the CHARLS. BMC Public Health, 25(1). https://doi.org/10.1186/s12889-025-24746-1
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