Nutrition (Burbank, Los Angeles County, Calif.) · 2026
Bioelectrical impedance analysis-based Sarcopenic Obesity Phenotype Index versus sarcopenic obesity: associations with frailty, falls, and osteoporosis in community-dwelling older adults.
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Kayhan Kocak Fatma Ozge, Altın Zeynep
Аннотация
OBJECTIVES: The aim of this study was to examine the associations between the bioelectrical impedance analysis-based Sarcopenic Obesity Phenotype Index (SOPi) and frailty, osteoporosis, and fall-related outcomes in community-dwelling older adults and to compare its performance with a categorical definition of sarcopenic obesity based on European Society for Clinical Nutrition and Metabolism-European Association for the Study of Obesity criteria.
METHODS: In this retrospective study, 1154 consecutive medical records of community-dwelling older adults were screened. After exclusion, 395 individuals were included in the final analysis. The SOPi was constructed as a continuous index using sex-specific z scores of body fat percentage, handgrip strength, and skeletal muscle mass normalized to body weight. Sarcopenic obesity was also defined categorically according to European Society for Clinical Nutrition and Metabolism-European Association for the Study of Obesity-aligned criteria. Flarity was assessed using the Clinical Frailty Index. Osteoporosis was defined according to bone mineral density-based clinical diagnoses, and fall-related outcomes were also evaluated.
RESULTS: Both categorical sarcopenic obesity and the SOPi were independently associated with frailty; however, the SOPi demonstrated a graded, stepwise increase in frailty severity when modeled as a continuous variable (β = 0.04, P = 0.019). Categorical sarcopenic obesity was not independently associated with osteoporosis (P > 0.05), whereas the SOPi showed significant associations when analyzed both in quartiles and as a continuous variable (odds ratio per unit increase, 0.82, 95% confidence interval, 0.73-0.93, P = 0.001). Neither approach was significantly associated with a history of falls or unsteadiness; however, individuals in the highest SOPi quartile had significantly higher odds of fear of falling compared with those in the lowest quartile (odds ratio, 2.40, 95% confidence interval, 1.17-4.94, P = 0.017).
CONCLUSIONS: The bioelectrical impedance analysis-based SOPi captures graded clinical vulnerability beyond categorical definitions, particularly for bone health and perceived fall-related risk. The SOPi may offer added value for clinical risk stratification in geriatric practice.
METHODS: In this retrospective study, 1154 consecutive medical records of community-dwelling older adults were screened. After exclusion, 395 individuals were included in the final analysis. The SOPi was constructed as a continuous index using sex-specific z scores of body fat percentage, handgrip strength, and skeletal muscle mass normalized to body weight. Sarcopenic obesity was also defined categorically according to European Society for Clinical Nutrition and Metabolism-European Association for the Study of Obesity-aligned criteria. Flarity was assessed using the Clinical Frailty Index. Osteoporosis was defined according to bone mineral density-based clinical diagnoses, and fall-related outcomes were also evaluated.
RESULTS: Both categorical sarcopenic obesity and the SOPi were independently associated with frailty; however, the SOPi demonstrated a graded, stepwise increase in frailty severity when modeled as a continuous variable (β = 0.04, P = 0.019). Categorical sarcopenic obesity was not independently associated with osteoporosis (P > 0.05), whereas the SOPi showed significant associations when analyzed both in quartiles and as a continuous variable (odds ratio per unit increase, 0.82, 95% confidence interval, 0.73-0.93, P = 0.001). Neither approach was significantly associated with a history of falls or unsteadiness; however, individuals in the highest SOPi quartile had significantly higher odds of fear of falling compared with those in the lowest quartile (odds ratio, 2.40, 95% confidence interval, 1.17-4.94, P = 0.017).
CONCLUSIONS: The bioelectrical impedance analysis-based SOPi captures graded clinical vulnerability beyond categorical definitions, particularly for bone health and perceived fall-related risk. The SOPi may offer added value for clinical risk stratification in geriatric practice.