Prevalence and clinical characterization of malnutrition, sarcopenia and sarcopenic obesity in older adults with cardiometabolic diseases: SENIOR cross-sectional study

Malnutrition, sarcopenia, and sarcopenic obesity may coexist with excess adiposity and cardiometabolic diseases in aging populations, but their combined burden and inflammatory profile remain insufficiently characterized. This study examined their prevalence and overlap in older adults with cardiometabolic diseases and explored associations with metabolic syndrome, multidimensional health-related factors and inflammation. In this cross-sectional study 303 Caucasian adults aged ≥ 65 years were recruited from a General Medicine ward and an Endocrinology and Metabolic Diseases outpatient clinic in Northern Italy. Malnutrition, sarcopenia, sarcopenic obesity, and metabolic syndrome were identified according to the GLIM, EWGSOP2, ESPEN/EASO, and IDF criteria, respectively. Sociodemographic, clinical, anthropometric, body composition, lifestyle, functional, psychological, and biochemical variables were collected using standardized procedures. CRP, WBC, platelet counts, prealbumin, uric acid, and circulating cytokines (IL-6, IL-10, TNF-α, and TGF-β) provided complementary information on inflammatory, nutritional, and metabolic status. The prevalence of malnutrition, sarcopenia, sarcopenic obesity, probable sarcopenia, and metabolic syndrome was 39.9%, 30.9%, 9.4%, 42.6%, and 60.1%, respectively, and was generally higher in inpatients. 13.2% of malnourished patients suffered from overweight or obesity, while malnutrition and sarcopenia overlapped in 29.2%. Older age, functional dependence, poorer physical health-related quality of life, and BMI class were associated with malnutrition or sarcopenia, whereas sarcopenic obesity was associated with age 75–84 years and low physical activity. Metabolic syndrome was significantly associated with malnutrition, sarcopenia, and sarcopenic obesity. Higher circulating IL-6 concentrations were observed in older participants and in those with sarcopenic obesity or metabolic syndrome. Malnutrition, sarcopenia, sarcopenic obesity, and metabolic syndrome are highly prevalent and overlapping conditions among older adults with cardiometabolic diseases, especially in hospitalized patients. Excess body weight does not exclude nutritional or muscle impairment, thus integrated assessment is needed to identify vulnerable older adults and guide targeted interventions.