Vestnik Vosstanovitelnoy Meditsiny · 2026
Obesity and Sarcopenic Obesity in Older Adults: Specifics of Geriatric Status and Cardiorespiratory Fitness (A Prospective Controlled Study)
By Arefeva M.S., Kolesnikova E.A., Eruslanova K.A. et al.
INTRODUCTION. The absence of well-defined diagnostic criteria and a general lack of awareness regarding the symptoms of sarcopenic obesity (SO) in older adults hinder prompt diagnosis. This underscores the need for research into its prevalence and clinical-functional traits to devise tailored management strategies. AIM. To identify differences in clinical and functional characteristics (including an assessment of cardiorespiratory fitness based on cardiorespiratory exercise testing), metabolic and socio-demographic characteristics between patients aged ≥ 60 years with and without obesity; and, within the obese group, to compare subgroups with SO and obesity without sarcopenia to define phenotypic markers. MATERIALS AND METHODS. The study was conducted at the Russian Clinical and Research Center of Gerontology from 2024 to 2026. Data from 109 patients (72.2 ± 6.88 years; 75.2 % female; 24.8 % male; 46.8 % obesity; 42.2 % frailty) were analyzed. All underwent comprehensive geriatric assessment, bioelectrical impedance analysis, cardiopulmonary exercise testing. The formed groups included: patients with obesity (n = 51; 72.0 ± 6.26 years; 80.4 % female) and without obesity (n = 58; 72.3 ± 7.44 years; 70.7 % female). Among obesity patients, SO (n = 13; 75.7 ± 8.21 years; 100 % female) and Non-SO (n = 38; 71.1 ± 6.59 years; 74.4 % female) were identified. RESULTS. In obesity group, compared to non-obese patients, we observed lower cardiorespiratory fitness (peak oxygen consumption 14.29 ± 5.13 mL/kg/min vs 17.78 ± 5.17 mL/kg/min; p < 0.001), decreased strength index (p < 0.01) and mobility (p < 0.05), metabolic deterioration (hypertriglyceridemia, hyperglycemia, hyperuricemia, low high-density lipoprotein cholesterol) (p < 0.05), increased left atrial volume (p < 0.01). The proportion of SO among patients with obesity was 25.5 %. DISCUSSION. In comparison the SO and non-SO groups revealed significant differences (p < 0.05) across all analyzed parameters, including functional tests, cardiorespiratory fitness, cognitive and social status, lab markers, Charlson Comorbidity Index, and quality of life. CONCLUSION. Obesity in elderly is associated with reduced cardiorespiratory fitness, functional performance, metabolic profile deterioration. Sarcopenic obesity represents the most vulnerable phenotype with lower cardiorespiratory reserves and muscle strength, more severe geriatric status compared to non-SO; it is found in almost one in four patients with obesity, which necessitates active screening for SO and comprehensive, multidisciplinary management.