The journal of nutrition, health & aging

, Volume 23, Issue 1, pp 14–20 | Cite as

Associations between Sarcopenic Obesity and Cognitive Impairment in Elderly Chinese Community-Dwelling Individuals

  • H. Wang
  • S. Hai
  • Y. X. Liu
  • L. Cao
  • Y. Liu
  • P. Liu
  • Y. Yang
  • Birong DongEmail author



This study aimed to estimate the prevalence of sarcopenic obesity (SO) and the association between cognitive impairment and SO in a cohort of elderly Chinese community-dwelling individuals.


A total of 948 elderly Chinese community-dwelling individuals aged 60–92 years were recruited. The participants were categorized into the following four groups according to their sarcopenia and obesity status: sarcopenic obese, sarcopenic, obese and non-sarcopenic, and non-obese group. Sarcopenia was defined as appendicular skeletal muscle index of <7.0 kg/m2 in men and <5.7 kg/m2 in women; obesity was defined as values greater than the upper two quintiles for body fat percentage stratified by gender of the study population; cognitive impairment was measured using the Mini-Mental State Examination and defined as a score of <24.


A total of 945 participants were included in the statistical analyses with a mean age of 68.76 ± 6.50 years. The prevalence of SO was 6.0% (7.3% in men and 4.8% in women). The sarcopenic obese (odds ratio [OR]: 2.550, 95% confidence interval [CI], 1.196-5.435) and obese (ORs: 2.141, 95% CI, 1.230-3.728) groups had significantly increased risk for cognitive impairment in fully adjusted model, respectively.


The SO prevalence in elderly Chinese community-dwelling individuals was relatively low (6.0%). The present study suggested SO was independently associated with cognitive impairment.

Key words

Sarcopenia obesity sarcopenic obesity cognitive impairment 


  1. 1.
    Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127(5 Suppl):990S–1S.CrossRefGoogle Scholar
  2. 2.
    Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95–101.CrossRefGoogle Scholar
  3. 3.
    Han PP, Kang L, Guo Q, Wang JZ, Zhang W, Shen SX, et al. Prevalence and Factors Associated With Sarcopenia in Suburb-dwelling Older Chinese Using the Asian Working Group for Sarcopenia Definition. Journals of Gerontology Series a-Biological Sciences and Medical Sciences. 2016;71(4):529–35.CrossRefGoogle Scholar
  4. 4.
    Chan KY, Wang W, Wu JJ, Liu L, Theodoratou E, Car J, et al. Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990-2010: a systematic review and analysis. Lancet. 2013;381(9882):2016–23.CrossRefGoogle Scholar
  5. 5.
    Huang CY, Hwang AC, Liu LK, Lee WJ, Chen LY, Peng LN, et al. Association of Dynapenia, Sarcopenia, and Cognitive Impairment Among Community-Dwelling Older Taiwanese. Rejuvenation Research. 2016;19(1):71–8.CrossRefGoogle Scholar
  6. 6.
    Tolea MI, Galvin JE. Sarcopenia and impairment in cognitive and physical performance. Clin Interv Aging. 2015;10:663–71.CrossRefGoogle Scholar
  7. 7.
    Chang KV, Hsu TH, Wu WT, Huang KC, Han DS. Association Between Sarcopenia and Cognitive Impairment: A Systematic Review and Meta-Analysis. Journal of the American Medical Directors Association. 2016;17(12):1164.e7–.e15.CrossRefGoogle Scholar
  8. 8.
    Zamboni M, Mazzali G, Fantin F, Rossi A, Di Francesco V. Sarcopenic obesity: A new category of obesity in the elderly. Nutrition Metabolism and Cardiovascular Diseases. 2008;18(5):388–95.CrossRefGoogle Scholar
  9. 9.
    Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obesity Reviews. 2011;12(501):e426–e37.CrossRefGoogle Scholar
  10. 10.
    Atti AR, Palmer K, Volpato S, Winblad B, De Ronchi D, Fratiglioni L. Late-life body mass index and dementia incidence: Nine-year follow-up data from the kungsholmen project. Journal of the American Geriatrics Society. 2008;56(1):111–6.CrossRefGoogle Scholar
  11. 11.
    Miller SL, Wolfe RR. The danger of weight loss in the elderly. J Nutr Health Aging. 2008;12(7):487–91.CrossRefGoogle Scholar
  12. 12.
    Mathus-Vliegen EMH, Basdevant A, Finer N, Hainer V, Hauner H, Micic D, et al. Prevalence, Pathophysiology, Health Consequences and Treatment Options of Obesity in the Elderly: A Guideline. Obesity Facts. 2012;5(3):460–83.CrossRefGoogle Scholar
  13. 13.
    Prado CMM, Wells JCK, Smith SR, Stephan BCM, Siervo M. Sarcopenic obesity: A Critical appraisal of the current evidence. Clinical Nutrition. 2012;31(5):583–601.CrossRefGoogle Scholar
  14. 14.
    Baumgartner RN. Body composition in healthy aging. Ann N Y Acad Sci. 2000;904:437–48.CrossRefGoogle Scholar
  15. 15.
    Kohara K. Sarcopenic obesity in aging population: current status and future directions for research. Endocrine. 2014;45(1):15–25.CrossRefGoogle Scholar
  16. 16.
    Baumgartner RN, Wayne SJ, Waters DL, Janssen I, Gallagher D, Morley JE. Sarcopenic obesity predicts Instrumental Activities of Daily Living disability in the elderly. Obesity Research. 2004;12(12):1995–2004.CrossRefGoogle Scholar
  17. 17.
    Stephen WC, Janssen I. Sarcopenic-obesity and cardiovascular disease risk in the elderly. J Nutr Health Aging. 2009;13(5):460–6.CrossRefGoogle Scholar
  18. 18.
    Schrager MA, Metter EJ, Simonsick E, Ble A, Bandinelli S, Lauretani F, et al. Sarcopenic obesity and inflammation in the InCHIANTI study. J Appl Physiol (1985). 2007;102(3):919–25.CrossRefGoogle Scholar
  19. 19.
    Kim TN, Yang SJ, Yoo HJ, Lim KI, Kang HJ, Song W, et al. Prevalence of sarcopenia and sarcopenic obesity in Korean adults: the Korean sarcopenic obesity study. International Journal of Obesity. 2009;33(8):885–92.CrossRefGoogle Scholar
  20. 20.
    Ryu M, Jo J, Lee Y, Chung YS, Kim KM, Baek WC. Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey. Age and Ageing. 2013;42(6):734–40.CrossRefGoogle Scholar
  21. 21.
    Lee DC, Shook RP, Drenowatz C, Blair SN. Physical activity and sarcopenic obesity: definition, assessment, prevalence and mechanism. Future Science Oa. 2016;2(3).Google Scholar
  22. 22.
    Morley JE, Baumgartner RN, Roubenoff R, Mayer J, Nair KS. Sarcopenia. J Lab Clin Med. 2001;137(4):231–43.CrossRefGoogle Scholar
  23. 23.
    Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG. Sarcopenic Obesity and Risk of Cardiovascular Disease and Mortality: A Population-Based Cohort Study of Older Men. Journal of the American Geriatrics Society. 2014;62(2):253–60.CrossRefGoogle Scholar
  24. 24.
    Honda H, Qureshi AR, Axelsson J, Heimburger O, Suliman ME, Barany P, et al. Obese sarcopenia in patients with end-stage renal disease is associated with inflammation and increased mortality. American Journal of Clinical Nutrition. 2007;86(3):633–8.CrossRefGoogle Scholar
  25. 25.
    Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The Concept of Normal Weight Obesity. Prog Cardiovasc Dis. 2014;56(4):426–33.CrossRefGoogle Scholar
  26. 26.
    Tombaugh TN, Mcintyre NJ. The Mini-Mental-State-Examination -a Comprehensive Review. Journal of the American Geriatrics Society. 1992;40(9):922–35.CrossRefGoogle Scholar
  27. 27.
    Booth M. Assessment of physical activity: an international perspective. Research quarterly for exercise and sport. 2000;71 Suppl 2:114–20.CrossRefGoogle Scholar
  28. 28.
    Lim PPJ, Ng LL, Chiam PC, Ong PS, Ngui FTS, Sahadevan S. Validation and comparison of three brief depression scales in an elderly Chinese population. Int J Geriatr Psych. 2000;15(9):824–30.CrossRefGoogle Scholar
  29. 29.
    Omran ML, Morley JE. Assessment of protein energy malnutrition in older persons, part I: History, examination, body composition, and screening tools. Nutrition. 2000;16(1):50–63.CrossRefGoogle Scholar
  30. 30.
    Schrager MA, Metter EJ, Simonsick E, Ble A, Bandinelli S, Lauretani F, et al. Sarcopenic obesity and inflammation in the InCHIANTI study. Journal of Applied Physiology. 2007;102(3):919–25.CrossRefGoogle Scholar
  31. 31.
    Meng P, Hu Y-X, Fan L, Zhang Y, Zhang M-X, Sun J, et al. Sarcopenia and sarcopenic obesity among men aged 80 years and older in Beijing: Prevalence and its association with functional performance. Geriatr Gerontol Int. 2014;14:29–35.CrossRefGoogle Scholar
  32. 32.
    Ishii S, Chang C, Tanaka T, Kuroda A, Tsuji T, Akishita M, et al. The Association between Sarcopenic Obesity and Depressive Symptoms in Older Japanese Adults. PLoS ONE [Electronic Resource]. 2016;11(9):e0162898.CrossRefGoogle Scholar
  33. 33.
    Batsis JA, Barre LK, Mackenzie TA, Pratt SI, Lopez-Jimenez F, Bartels SJ. Variation in the prevalence of sarcopenia and sarcopenic obesity in older adults associated with different research definitions: dual-energy X-ray absorptiometry data from the National Health and Nutrition Examination Survey 1999–2004. J Am Geriatr Soc. 2013;61(6):974–80.CrossRefGoogle Scholar
  34. 34.
    Gustafson D, Rothenberg E, Blennow K, Steen B, Skoog I. An 18-year follow-up of overweight and risk of Alzheimer disease. Arch Intern Med. 2003;163(13):1524–8.CrossRefGoogle Scholar
  35. 35.
    Whitmer RA, Gustafson DR, Barrett-Connor E, Haan MN, Gunderson EP, Yaffe K. Central obesity and increased risk of dementia more than three decades later. Neurology. 2008;71(14):1057–64.CrossRefGoogle Scholar
  36. 36.
    Qizilbash N, Gregson J, Johnson ME, Pearce N, Douglas I, Wing K, et al. BMI and risk of dementia in two million people over two decades: a retrospective cohort study. Lancet Diabetes Endocrinol. 2015;3(6):431–6.CrossRefGoogle Scholar
  37. 37.
    Dahl AK, Lopponen M, Isoaho R, Berg S, Kivela SL. Overweight and obesity in old age are not associated with greater dementia risk. J Am Geriatr Soc. 2008;56(12):2261–6.CrossRefGoogle Scholar
  38. 38.
    Molino S, Dossena M, Buonocore D, Verri M. Sarcopenic obesity: An appraisal of the current status of knowledge and management in elderly people. J Nutr Health Aging. 2016;20(7):780–8.CrossRefGoogle Scholar
  39. 39.
    Levine ME, Crimmins EM. Sarcopenic obesity and cognitive functioning: the mediating roles of insulin resistance and inflammation? Curr Gerontol Geriatr Res. 2012;2012:826398.CrossRefGoogle Scholar
  40. 40.
    Schram MT, Euser SM, de Craen AJ, Witteman JC, Frolich M, Hofman A, et al. Systemic markers of inflammation and cognitive decline in old age. J Am Geriatr Soc. 2007;55(5):708–16.CrossRefGoogle Scholar
  41. 41.
    Yaffe K, Kanaya A, Lindquist K, Simonsick EM, Harris T, Shorr RI, et al. The metabolic syndrome, inflammation, and risk of cognitive decline. JAMA. 2004;292(18):2237–42.CrossRefGoogle Scholar
  42. 42.
    Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity: definition, cause and consequences. Current Opinion in Clinical Nutrition and Metabolic Care. 2008;11(6):693–700.CrossRefGoogle Scholar
  43. 43.
    Waters DL, Qualls CR, Dorin RI, Veldhuis JD, Baumgartner RN. Altered growth hormone, cortisol, and leptin secretion in healthy elderly persons with sarcopenia and mixed body composition phenotypes. J Gerontol A Biol Sci Med Sci. 2008;63(5):536–41.CrossRefGoogle Scholar
  44. 44.
    Baker LD, Barsness SM, Borson S, Merriam GR, Friedman SD, Craft S, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Arch Neurol. 2012;69(11):1420–9.CrossRefGoogle Scholar
  45. 45.
    Lang T, Streeper T, Cawthon P, Baldwin K, Taaffe DR, Harris TB. Sarcopenia: etiology, clinical consequences, intervention, and assessment. Osteoporosis International. 2010;21(4):543–59.CrossRefGoogle Scholar
  46. 46.
    Roubenoff R. Sarcopenic obesity: The confluence of two epidemics. Obesity Research. 2004;12(6):887–8.CrossRefGoogle Scholar
  47. 47.
    De Felice FG, Lourenco MV, Ferreira ST. How does brain insulin resistance develop in Alzheimer’s disease? Alzheimers & Dementia. 2014;10:S26–S32.CrossRefGoogle Scholar
  48. 48.
    Convit A. Links between cognitive impairment in insulin resistance: an explanatory model. Neurobiology of aging. 2005;26 Suppl 1:31–5.CrossRefGoogle Scholar
  49. 49.
    Abbatecola AM, Paolisso G, Lamponi M, Bandinelli S, Lauretani F, Launer L, et al. Insulin resistance and executive dysfunction in older persons. J Am Geriatr Soc. 2004;52(10):1713–8.CrossRefGoogle Scholar
  50. 50.
    Wang H, Hai S, Cao L, Zhou JH, Liu P, Dong BR. Estimation of prevalence of sarcopenia by using a new bioelectrical impedance analysis in Chinese community-dwelling elderly people. Bmc Geriatrics. 2016;16.Google Scholar

Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • H. Wang
    • 1
    • 3
  • S. Hai
    • 1
  • Y. X. Liu
    • 1
  • L. Cao
    • 1
  • Y. Liu
    • 1
  • P. Liu
    • 1
  • Y. Yang
    • 2
  • Birong Dong
    • 1
    Email author
  1. 1.Center of Gerontology and Geriatrics, West China HospitalSichuan UniversityChengduChina
  2. 2.The Fifth People’s Hospital of ChengduChengduChina
  3. 3.Collaborative Innovation Center of Sichuan for Elderly Care and HealthChengduChina

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