Sarcopenic Obesity in Older Adults with Type 2 Diabetes: Measuring What the BMI Hides
DOI:
https://doi.org/10.5281/zenodo.22258293Keywords:
Sarcopenic obesity, Type 2 diabetes, Body composition, Muscle strength, Diagnostic criteriaAbstract
Sarcopenic obesity is the coexistence of excess adiposity with low muscle mass or strength, and in older adults with type 2 diabetes
it is common and largely invisible to routine measurement. The problem is structural: body mass index cannot distinguish muscle
from fat, and the standard sarcopenia definitions were built for people who are not obese. In a cohort of older men, 60.8 per cent
of those with a body mass index of 32 or above had low muscle strength, and the conventional sarcopenia criteria classified none
of them as sarcopenic, while a consensus definition designed for obesity identified 9.6 per cent. Those identified had significantly
weaker grip, slower gait and longer chair-stand times, with five times the odds of disability in basic daily activities and a raised
rate of falls. Definition still determines prevalence: in 90 hospitalised older adults with severe obesity, four permitted
combinations of tests produced figures of 23.3, 25.5, 31.1 and 40.0 per cent in the same people. This review sets out what is
measurable, what the numbers depend on, and why weight alone conceals the finding.
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