Association of sarcopenia, sarcopenic obesity, and frailty with muscle strength and gait speed in older adults: A systematic review

Jagadeesh  Dhamodharan; Mrunal  Phatak; Jacquilyne  Kharlukhi; E.  Lakshmi; Mirra  Rajalakshmi. M; Uthamalingam  Murali; Rajkumar  Krishnan Vasanthi; Merriwin  David; Muthu  Prasanna

Authors

Jagadeesh Dhamodharan Unit of Anatomy, Faculty of Medicine, AIMST University, Kedah, Malaysia
Mrunal Phatak AIIMS Nagpur, India
Jacquilyne Kharlukhi Sree Balaji Medical College and Hospital, Chennai, Tamilnadu, India
E. Lakshmi SRM School of Allied Health Sciences, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, India.
Mirra Rajalakshmi. M Chengalpattu Government Medical College, Chengalpattu, India
Uthamalingam Murali Manipal University College Malaysia, Melaka, Malaysia
Rajkumar Krishnan Vasanthi Faculty of Health and Life Sciences, INTI International University, Nilai, Negeri Sembilan, Malaysia
Merriwin David Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamilnadu, India
Muthu Prasanna Surya School of Pharmacy, Vikiravandi, Villupu-ram Dt. Tamil Nadu, India

Keywords:

Frailty, gait speed, muscle strength, older adults sarcopenia, sarcopenic obesity

Abstract

Background: Sarcopenia, sarcopenic obesity (SO), and frailty are interrelated geriatric conditions associated with adverse health outcomes and increased health risks, including reduced muscle strength, impaired gait speed, and increased morbidity. However, their shared clinical features and biomarkers remain inadequately synthesized.

Objective: This systematic review aims to evaluate the interrelationship between sarcopenia, SO, and frailty in older adults, with a particular focus on muscle strength, gait speed, and associated biomarkers.

Methods: A comprehensive literature search was performed across MEDLINE, EMBASE, Scopus, Web of Science, and CINAHL. Observational and clinical studies assessing sarcopenia, SO, and frailty were included. Data were extracted using the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework, and the findings were synthesized narratively. Risk of bias was assessed using appropriate tools.

Results: Reduced muscle strength and slower gait speed were consistently associated with a higher prevalence of sarcopenia, SO, and frailty across the included studies. The pooled analysis demonstrated a non-significant association between SO and frailty, with a pooled odds ratio (OR) indicating substantial heterogeneity among the included studies (I² = 97.8%).

Conclusion: Sarcopenia, SO, and frailty share overlapping clinical and biological characteristics, including reduced muscle strength, impaired gait speed, and common metabolic and inflammatory pathways. Although individual studies frequently reported positive associations between SO and frailty, the pooled meta-analysis did not reveal a significant association (OR 1.81, 95% confidence interval 0.66–4.91; P = 0.25), likely reflecting substantial heterogeneity across the studies. Further standardized longitudinal studies are required to clarify this relationship. Muscle strength and gait speed are key indicators that provide insight into the underlying pathways. Standardized assessment and further research are required to improve clinical management.

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