Effectiveness of using simple measures as screening indicators for sarcopenic obesity to predict mortality risk in older male patients: a prospective study

This study was developed to determine whether sarcopenic obesity (SO), as identified using screening indices for sarcopenia and obesity, could predict mortality risk among older male individuals. This prospective study enrolled male patients aged ≥ 60 years from 15 nursing homes in Zigong, China. Baseline data were collected from September 2021 to July 2022, with follow-up conducted until April 2024. Three parameters were used to identify SO, namely, handgrip strength (HGS), calf circumference (CC), and several obesity indices (waist-to-hip ratio [WHR], body mass index [BMI], waist circumference [WC], and WC_BMI). The HGS and CC cut-off values were selected based on the Asian Working Group on Sarcopenia (AWGS) 2019 consensus criteria. The WHR, BMI, and WC values were used to stratify patients by obesity status using previously published cut-off values. The cutoff value of WC_BMI was determined according to the third quartile. SO was defined by abnormalities in all three parameters, and the relationship between SO and mortality was examined using Cox proportional hazards models. A total of 491 subjects in nursing homes were enrolled in the study. 72 (14.66%) of the participants died between the baseline and end of follow-up. Of these, deceased males showed significantly lower CC, HGS, WC, and BMI but higher WC_BMI values compared to survivors (all P < 0.05). Mortality was significantly higher in subjects with low CC (18.13% vs. 5.8%, P < 0.001), low HGS (17.93% vs. 5.97%, P < 0.01), and high WC_BMI (25.83% vs. 11.05%, P < 0.001), and lower in those with high WC (17.37% vs. 8.92%, P < 0.05). Using low CC + low HGS+high WC_BMI as criteria for diagnosing SO, Cox regression analysis showed that the risk of death in the SO group was higher than that in the normal group (HR = 3.07, 95% CI: 1.846–5.108). The findings indicate that low CC and HGS, as well as high WC_BMI, were significant independent predictors of mortality in older male nursing home residents. The findings demonstrate the clinical utility of incorporating CC and HGS measurements into routine geriatric assessments in long-term care facilities. Furthermore, the results highlight the need for sex-specific preventive strategies and indicate that WC_BMI may represent a more meaningful anthropometric indicator than traditional BMI for mortality risk stratification in older individuals. These evidence-based insights could significantly improve risk assessment and inform targeted interventions to reduce mortality in this vulnerable demographic.