Dynapenic abdominal obesity and incident multimorbidity: findings from the English longitudinal study on ageing

Dynapenic Abdominal Obesity and Adverse Health Effects in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis

BACKGROUND/OBJECTIVES

Dynapenic abdominal obesity is characterized by reduced muscle strength and abdominal fat accumulation and is associated with adverse health outcomes in older adults. Evidence from multiple studies conducted in different countries regarding these outcomes is inconsistent. This systematic review and meta-analysis evaluated the association between dynapenic abdominal obesity and adverse health outcomes-specifically falls, disability, and mortality-among middle-aged and older adults.

METHODS

A comprehensive search of Embase, PubMed, MEDLINE, CINAHL, and the Cochrane Library (from inception to December 2024) identified 12 eligible prospective cohort studies. Keywords included "older adults", "elderly", "older people", "dynapenic abdominal obesity", "fall", "disability", and "mortality". A systematic review and meta-analysis was conducted using random-effects models, with subgroup analyses based on measurement methods and geographic regions.

RESULTS

Dynapenic abdominal obesity was significantly associated with increased risks of falls (hazard ratio = 1.82, 95% confidence interval: 1.04-3.17) and mortality (hazard ratio = 1.50, 95% confidence interval: 1.14-1.96). The subgroup analysis results indicated variations in outcomes across measurement criteria and countries. Dynapenic abdominal obesity was not significantly associated with disability risk (odds ratio = 0.92, 95% confidence interval: 0.18-4.54).

CONCLUSIONS

Dynapenic abdominal obesity is associated with significantly increased fall and mortality risks in middle-aged and older adults. These findings underscore the need for targeted assessments and intervention strategies for high-risk groups.

Longitudinal Cohort Study Investigating Fall Risk Across Diverse Muscle Health Statuses Among Older People in the Community

BACKGROUND

Falls constitute a significant public health concern among older adults, particularly those with diminished muscle health integrity. The relative contributions of reduced muscle mass versus impaired muscle function to fall risk remain debated. Discrepant conclusions in previous studies exist due to divergent muscle health categorizations and parameter measurements. This study investigated longitudinal risk of falls across a spectrum of muscle health statuses among older people in the community.

METHODS

Community-dwelling participants aged 65 years and older, undergoing annual health assessments, were enrolled between 2015 and 2023. Measurements included handgrip strength, walking speed and appendicular skeletal muscle mass. Dynapenia was defined as impaired muscle function with preserved muscle mass, presarcopenia was characterized as reduced muscle mass with maintained muscle function, and sarcopenia was identified as concurrent losses in both muscle mass and muscle function. Older people with normal muscle mass and muscle function were defined as having a robust muscle health status. Participants without a history of falls at baseline were monitored continuously and were censored if a fall incident was recorded during later yearly assessment. Kaplan-Meier and Cox regression analyses were used to compare fall risk across different muscle health statuses.

RESULTS

The final analysis included a total of 863 participants with a mean age of 71.93 ± 6.62 years, and 57.58% were female. Compared with the other groups, the dynapenic group exhibited a lower physical activity, greater body mass index and slower gait speed. The participants with dynapenia experienced the highest fall incidence (27.15%). The hazard ratios (HRs) for fall were 2.65 (95% confidence interval [CI] = 1.72-4.08, p < 0.001) for dynapenia, 1.54 (95% CI = 0.92-2.57, p = 0.095) for presarcopenia and 1.87 (95% CI = 1.04-3.33, p = 0.034) for sarcopenia. After adjustment for multiple covariates, the fall risk remained significantly greater in the dynapenic group (HR = 2.10, 95% CI = 1.28-3.43, p = 0.003) than in the sarcopenic group (HR = 1.31, 95% CI = 0.69-2.46, p = 0.402). Female dynapenic participants with coronary artery disease, arthritis and sedative agent use had a high fall risk, especially those with two or more risk factors (HR = 2.82, 95%CI = 1.37-5.82, p = 0.005).

CONCLUSIONS

Older adults with dynapenia exhibited a greater fall risk than did those with sarcopenia. Dynapenic older people with two or more risk factors, such as female sex, coronary artery disease, arthritis and sedative agent use, may have an increased longitudinal fall risk. Promoting muscle function should be prioritized as a preventive strategy to mitigate adverse clinical outcomes.

Association between Dynapenia and Multimorbidity in Community-Dwelling Older Adults: A Systematic Review

Dynapenia and multimorbidity are common health problems affecting older adults. However, few studies have systematically reviewed the association between dynapenia and multimorbidity. Therefore, this systematic review aimed to provide a comprehensive overview of studies on the association between these conditions. We searched four electronic databases for relevant articles published in July 2023. The main inclusion criteria were the following: a description of dynapenia, which indicates loss of muscle strength, and a description of multimorbidity with two or more chronic diseases. Five studies met these inclusion criteria. In all five of these studies, the participants were community-dwelling older adults. All the studies showed an association between dynapenia and multimorbidity. The prevalence of dynapenia and multimorbidity ranged from 16% to 25.9%. The results of our systematic review demonstrated that dynapenia in older adults increases the risk of multimorbidity. We propose that interventions and reversible changes in dynapenia can prevent multimorbidity. (PROSPERO Registration No. CRD42023443282).

Dynapenic abdominal obesity and the risk of depressive symptoms in middle-aged and older Chinese adults: Evidence from a national cohort study

BACKGROUND

Population-based evidence on the relationship between dynapenic abdominal obesity and depressive symptoms is rare. We aimed to prospectively investigate the relationship between dynapenic abdominal obesity and depressive symptoms among middle-aged and older Chinese adults.

METHODS

A total of 9322 participants free of depressive symptoms in the China Health and Retirement Longitudinal Study were included. The participants were divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO) according to the sex-specific grip strength (<28 kg for men and <18 kg for women) and waist circumference (≥85 cm for men and ≥80 cm for women) that in line with the Chinese criteria. Depressive symptoms was defined as a score of ≥12 for the 10-item Center for Epidemiological Studies Depression Scale. Logistic regression model was used to explore the association between dynapenic abdominal obesity and depressive symptoms.

RESULTS

After an approximately 3-year of follow-up, 1810 participants (19.4 %) developed depressive symptoms. The multivariable-adjusted odds ratio for the D/AO versus ND/NAO was 1.61 (95 % CI: 1.31-1.98) for depressive symptoms. In addition, this relationship was more profound in participants aged<60 years (OR = 2.27, 95 % CI: 1.60-3.22) than participants aged ≥60 (OR = 1.36, 95 % CI: 1.05-1.77; P-interaction = 0.04). However, dynapenic obesity (defined by body mass index) was not linked to depressive symptoms.

LIMITATIONS

Causal link and residual confounding were not addressed because of the observational study design.

CONCLUSIONS

Dynapenic abdominal obesity was associated with an increased risk of depressive symptoms, especially among those aged<60 years.

Dynapenic Abdominal Obesity and Metabolic Health in Non-Geriatric Patients with Obesity

Background: Dynapenic abdominal obesity (DAO) is the combination of low muscle strength and high central adiposity, which can lead to functional and cardiometabolic impairments. Objective: The aim of this study was to examine the relationship between DAO and metabolic parameters in non-geriatric patients with obesity. Methods: All patients seen in the obesity outpatient clinic during a random month, along with 30 healthy individuals, were included in the study. Body mass index (BMI), waist circumference (WC), hip circumference (HC), serum fasting blood glucose, triglyceride, high-density lipoprotein, low-density lipoprotein (LDL), insulin, and glycated hemoglobin (HbA1c) levels were measured. Muscle function tests were conducted. Hypertension and diabetes mellitus diagnoses were recorded. DAO was determined using handgrip strength and WC. Metabolic syndrome was defined based on International Diabetes Federation (IDF) criteria. Data were analyzed using SPSS. Results: A total of 106 individuals participated in the study, including 76 individuals with obesity as the case group and 30 healthy individuals as the control group. In the case group, BMI, WC, HC, and chair stand test results were higher compared to the control group. There was no significant difference between the case and control groups in terms of gait speed or handgrip test results. In the case group, 30 people (39.5%) had dynapenic obesity (DO), and in the control group, 8 people (26.7%) had DO. There was no significant difference in DO rates between the case and control groups. In the case group, the HbA1c level was higher in DO (+) group than DO (-) group. In the control group, DO (+) group had higher LDL and HbA1c level than DO (-) group. No significant difference was observed in other search parameters between the DO (+) and DO (-) groups in both the case and control groups. Conclusion: DAO is common among people with obesity and contributes to a poor prognosis, increased morbidity, and mortality. Therefore, including its treatment in the management of obesity is crucial for individuals of all age ranges.