Preoperative assessment of sarcopenia and osteosarcopenia prevalence in bariatric surgery candidates over 60

BACKGROUND: The prevalence of obesity in adults over 60 is rising, presenting challenges for healthcare systems. Bariatric surgery (BS) is increasingly considered for older adults, but complex health risk such as sarcopenic obesity (SO) and osteosarcopenic obesity (OSO) need evaluation to optimize clinical outcomes and guide preoperative risk stratification. OBJECTIVES: The aims was to describe the prevalence and severity of SO, OSO, and to examine the associated health consequences in BS candidates over 60 years. SETTING: This prospective cross-sectional study was conducted at a single tertiary care university hospital. METHODS: Cross-sectional study of 109 BS candidates over 60 years. The assessments included anthropometry, body composition (BC), muscle strength and function, bone mineral density (BMD), physical activity (PA) levels and metabolic pathologies associated with obesity. SO and OSO were defined using ESPEN/EASO (2022) consensus criteria. RESULTS: The mean age of the participants was 64.1 (2.9), and, 36 % were male. The prevalence of SO was 42 %, with no significant differences between sexes. This prevalence was primarily due to greater impairment in the 5-times sit-to-stand test (39.8 %). The prevalence of OSO was 26.8 %, largely attributed to a higher prevalence of osteopenia in females. Among obesity-related pathologies, only obstructive sleep apnea was more prevalent in males. Those with SO had a lower BMD and PA levels. CONCLUSIONS: The high prevalence of SO and OSO in BS candidates over 60 highlights the importance of comprehensive preoperative assessment. Sex and age-specific differences in BC and sarcopenia severity underscore the need for tailored interventions.