Global prevalence of, and factors associated with, sarcopenic and osteosarcopenic obesity in the community older adults: a systematic review and meta-analysis

Sarcopenic obesity (SO) and osteosarcopenic obesity (OSO, referring to the simultaneous loss of muscle mass and function, reduced bone density, and obesity) are major concerns in the older adults, but their global epidemiology is poorly understood among this population. Therefore, this systematic review and meta-analysis aimed to estimate the global prevalence of SO and OSO among community-dwelling older adults and to identify associated factors. We searched Embase, PubMed, Scopus, and Web of Science databases from inception to 31 March 2026. We included observational studies evaluating the prevalence of, and/or and factors associated with, SO and/or OSO in the community older adults. We excluded surveys performed on special populations. The collected data were combined using a random-effects model. Overall, 98 studies comprising more than 190 thousand participants from 27 countries met the eligibility criteria. Analyses showed that the pooled prevalence rates of SO and OSO were 9.1% (95% confidence interval [CI]: 7.4–10.8; I 2 = 99.7%) and 8.5% (95% CI: 2.9–14.0; I 2 = 99.9%), respectively, in the older adults. There were significant variations in the pooled prevalence by geographical regions and diagnostic criteria for sarcopenia and obesity. Potential factors associated with SO were sex (men), older age, diabetes, hypertension, dyslipidemia, insufficient energy intake, low physical activity, and unemployment. The prevalence of SO and OSO is considerable in older adults and can vary geographically. However, the pooled prevalence estimates should be interpreted cautiously because of substantial between-study heterogeneity. Implementing early screening programs, promoting physical activity, improving nutritional status, and controlling metabolic diseases seem to be necessary in this population.