Journal of the American Medical Directors Association · Jul 2, 2026

Sarcopenic Obesity in Older Korean Adults: Comparison of 2 Diagnostic Frameworks and Functional Outcomes

By Hyeon J

OBJECTIVES: To compare the prevalence and diagnostic agreement of sarcopenic obesity (SO) defined by the European Society for Clinical Nutrition and Metabolism (ESPEN)/European Association for the Study of Obesity (EASO) framework and Asian Working Group for Sarcopenia (AWGS) criteria and to examine associations with functional outcomes among older Korean adults. DESIGN: Cross-sectional analysis of a nationally representative population survey. SETTING AND PARTICIPANTS: Community-dwelling older adults aged ≥65 years participating in the Korea National Health and Nutrition Examination Survey 2022 to 2024. METHODS: Prevalence and diagnostic agreement were evaluated in 3831 adults aged ≥65 years. Associations with physical function, health-related quality of life, and falls were examined in a subsample of 1459 participants from the 2024 survey cycle. Multivariable logistic regression models were adjusted for sociodemographic, lifestyle, nutritional, and mental health factors. All analyses incorporated sampling weights and the complex survey design. RESULTS: The prevalence of SO was 5.11% using the ESPEN/EASO framework and 2.09% using the AWGS criteria. Diagnostic agreement between definitions was moderate (κ = 0.49). In adjusted analyses, ESPEN-defined SO was significantly associated with low physical function (adjusted odds ratio, 2.64; 95% CI, 1.08-6.47), whereas associations with low health-related quality of life or falls were not significant after multivariable adjustment in this cross-sectional analysis. CONCLUSIONS AND IMPLICATIONS: The ESPEN/EASO framework identified a larger subgroup of older adults with SO than the AWGS criteria. The broader ESPEN-defined group was associated with poorer physical function, although an independent association with fall risk was not observed in this cross-sectional analysis. These findings suggest that diagnostic frameworks incorporating direct adiposity assessment and muscle dysfunction may help identify older adults at risk of functional limitation.

doi.org/10.1016/j.jamda.2026.106320PubMed 42391772Populations