Dynapenic Abdominal Obesity and Disability in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.

Background

Dynapenic abdominal obesity (DAO), the coexistence of low muscle strength and abdominal obesity, may accelerate disability. However, its longitudinal association with disability remains unclear. In this study, we examined the relationship between DAO and disability in middle-aged and older adults.

Methods

A systematic review and random-effects meta-analysis of prospective cohort studies was conducted to examine longitudinal associations following the PRISMA 2020 guidelines (PROSPERO: CRD42024609352). Comprehensive database searches were conducted in PubMed, Embase, MEDLINE (Ovid), CINAHL (EBSCOhost), and the Cochrane Library from database inception through 31 January 2025. To ensure that the review reflected the most recent evidence prior to manuscript submission, an updated search using the same search strategy and eligibility criteria was conducted on 31 May 2026. When multiple effect estimates were reported, the most fully adjusted estimates were selected. Because odds ratios (ORs) and hazard ratios (HRs) are different effect measures and are not directly comparable, they were analyzed separately. A random-effects model was used for quantitative synthesis.

Results

Five cohort studies (n = 33,670; mean follow-up: 5.3 years) were included. Of these, four studies reported adjusted ORs and one reported an HR. DAO was associated with significantly higher odds of disability (pooled OR = 2.13, 95% CI: 1.74-2.60, I2 = 0%). Subgroup analyses demonstrated significant associations across predominant population types and age groups, with ORs ranging from 2.09 to 2.18.

Conclusions

DAO is associated with increased odds of future disability across population types and age groups. These findings highlight the importance of early identification of DAO and suggest that interventions targeting muscle strength and abdominal obesity represent promising strategies for disability prevention; however, their effectiveness should be confirmed in future prospective intervention studies.