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Sarcopenia, physical frailty, undernutrition and obesity cooccurrence among Portuguese community-dwelling older adults: results from Nutrition UP 65 cross-sectional study
  1. Ana Rita Sousa-Santos1,
  2. Cláudia Afonso1,2,
  3. Nuno Borges1,3,
  4. Alejandro Santos1,4,
  5. Patrícia Padrão1,2,
  6. Pedro Moreira1,2,5,
  7. Teresa F Amaral1,6
  1. 1FCNAUP - Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
  2. 2EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
  3. 3CINTESIS - Centro de Investigação em Tecnologia e Serviços de Saúde, Porto, Portugal
  4. 4I3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
  5. 5CIAFEL - Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
  6. 6UISPA, LAETA-INEGI - Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
  1. Correspondence to Dr Ana Rita Sousa-Santos; anaritadesousasantos{at}


Objectives To investigate the coexistence of sarcopenia, frailty, undernutrition and obesity and to identify the factors associated with the cooccurrence of these conditions in an older population.

Design Cross-sectional.

Setting Portugal.

Participants 1454 older adults with 65 years or older, from Nutrition UP 65 study.

Primary and secondary outcome measures Sarcopenia was identified using the European Working Group on Sarcopenia in Older People 2 guidelines and physical frailty using Fried phenotype. Mini-Nutritional Assessment-Short Form was used to ascertain undernutrition, and obesity was evaluated by body mass index.

Results 57.3% presented at least one condition, 38.0% were identified with one and 19.3% were identified with two or more conditions. When all preconditions were considered, 95.7% of the older adults presented at least one of these preconditions or conditions. Multinomial logistic regression multivariate analysis revealed that being male (OR 0.61; 95% CI 0.43 to 0.88), being married or in a common-law marriage (OR 0.58; 95% CI 0.40 to 0.84) and having a higher educational level (OR 0.23; 95% CI 0.07 to 0.73) were inversely associated with having two or more conditions, while age >75 years (OR 1.60; 95% CI 1.14 to 2.24), a poor self-perception of health status (OR 5.61; 95% CI 3.50 to 9.01), ≥5 medications (OR 3.11; 95% CI 1.77 to 5.46) and cognitive impairment (OR 1.84; 95% CI 1.37 to 2.48) were directly associated.

Conclusions Almost three out of five older adults presented at least one of the conditions related to nutritional status, and about one in five had two or more of these occurrences. However, the low coexistence observed between all of these reinforces the need to assess them all individually during the geriatric assessment.

  • frailty
  • obesity
  • sarcopenia
  • undernutrition
  • coexistent conditions

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  • Contributors ARSS and TFA designed this research and analysed all data. ARSS, CA, NB, AS, PP, PM and TFA contributed to manuscript preparation and approved the final version of the manuscript submitted for publication.

  • Funding The present project was 85% funded by the Public Health Initiatives Programme (PT06), financed by EEA Grants Financial Mechanism 2009–2014 and 15% funded by Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto. Also, Ana Rita Sousa-Santos as a PhD student received a scholarship from FCT—Fundação para a Ciência e a Tecnologia, financing programme POCH—Programa Operacional Capital Humano, under the project (SFRH/BD/138362/2018).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This research was conducted according to the guidelines established by the Declaration of Helsinki, and the study protocol was approved by the Ethics Committee of the department of ‘Ciências Sociais e Saúde’ (Social Sciences and Health) from the ‘Faculdade de Medicina da Universidade do Porto’ (PCEDCSS—FMUP 15/2015) and by the Portuguese National Commission of Data Protection (9427/2015). All study participants signed an informed consent form.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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