Prevalence and one-year transition of sarcopenic obesity in Taiwan - using new definition from Asia-Oceania sarcopenic obesity consensus.

Background

Sarcopenic obesity (SO) is a clinical and functional condition defined by the coexistence of obesity and sarcopenia. This study investigated the prevalence, incidence, and determinants of SO among Taiwanese older adults using the 2025 Asia-Oceania consensus.

Methods

Data were analyzed from 1048 participants (aged≧65 years) in the Taichung Community Health Study for Elders (TCHS-E). Questionnaires with basic information were conducted. Participants were categorized into healthy, possible SO, and SO groups based on body mass index, waist circumference, body composition including muscle mass and body fat percentage by DXA/BIA, and physical function. Comparisons of baseline characteristics between sexes and across different sarcopenic obesity (SO) status transitions were performed using the Chi-square test. Logistic regression identified risk factors for 1-year status changes.

Results

The baseline prevalence of SO was 2.0%, with women showing higher rates than men (2.6% vs. 1.5%, p < 0.001). The 1-year incidence of SO and possible SO was 1% and 3%, respectively. In fully adjusted models, hypertension (OR = 3.67, 95% CI: 1.26-10.66) and diabetes (OR = 4.01, 95% CI: 1.07-15.12) were independent predictors of SO deterioration. Conversely, regular exercise (OR = 0.46 in age/sex-adjusted models) and higher education were protective factors promoting improvement. Cognitive impairment also correlated with unfavorable SO trajectories.

Conclusions

While the 1-year incidence of SO is relatively low, female sex, advanced age, and cardiometabolic comorbidities significantly increase deterioration risk, whereas exercise and education serve as protective factors, highlighting the need for tailored, multidimensional prevention strategies.