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

Objectives To determine the prevalence range for sarcopenic obesity and its relationship with sex, age, and ethnicity. Design Cross-sectional analysis of a population-based sample. Setting Noninstitutionalized persons in the United States participating in the National Health and Nutrition Examination Surveys 1999-2004. Participants Subsample of 4,984 subjects aged 60 and older with dual-energy X-ray absorptiometry body composition data. Measurements Eight definitions of sarcopenic obesity identified from six studies found using a systematic literature review (Baumgartner, Bouchard, Davison, Zoico, Levine, Kim-1,2,3) were applied to the sample. Results were stratified according to sex, age, and ethnicity. Results Prevalence of sarcopenic obesity ranged from 4.4% to 84.0% in men and from 3.6% to 94.0% in women. Prevalence was higher in men using definitions from Baumgartner (17.9% vs 13.3%, P<.001), Levine (14.2% vs 6.6%, P<.001), and Kim-1 (30.0% vs 9.3%, P<.001); lower for men using the Davison (4.4% vs 11.1%, P<.001) and Kim-2 (83.7% vs 94.0%) definitions; and the same for men and women using the Bouchard (45.3% vs 44.3%, P=.32) and Kim-3 (75.6% vs 77.0%, P=.51) definitions. For all but one definition, sarcopenic obesity increased with each decade and was lower in non-Hispanic blacks than whites. Conclusion Prevalence of sarcopenic obesity in older adults varies up to 26-fold depending on current research definitions. Such a high degree of variability suggests the need to establish consensus criteria that can be reliably applied across clinical and research settings.