Author Identifier (ORCID)
Joshua R. Lewis: https://orcid.org/0000-0003-1003-8443
Richard L. Prince: https://orcid.org/0000-0002-2298-4202
Marc Sim: https://orcid.org/0000-0001-5166-0605
Abstract
Background and aims: Longitudinal studies have explored the association between sarcopenic obesity (SO) and the risk of cognitive impairment, yet findings remain mixed. This study aimed to investigate the associations of SO with risk of incident dementia in older women, using two diagnostic models: the Sarcopenic Obesity Global Leadership Initiative (SOGLI) and the load-capacity model. Methods: We analysed data from 900 community-dwelling women (aged ≥70 years). SO was defined using two models: (1) the SOGLI criteria, based on low handgrip strength (HGS), low appendicular lean soft tissue to body weight (ALST/W) ratio, and high fat mass percentage (%FM); and (2) the load-capacity model, based on a high truncal fat mass to ALST (TrFM/ALST) ratio. Incident dementia events (hospitalisation and/or death) over 9.5 years were identified through linked health records using International Classification of Diseases (ICD) codes. Cox proportional hazards and Fine-Gray sub-distribution models were applied. Results: Using the SOGLI criteria, SO was not significantly associated with the risk of overall dementia events compared with the non-sarcopenic, non-obesity group (hazard ratio [HR] 0.63, 95 % CI 0.39-1.03); however, SO was significantly associated with a reduced risk of dementia-related hospitalisation (HR 0.57, 95 % CI 0.33-0.98), mainly driven by the reduced risk observed with obesity. When defined by the load-capacity model, SO remained significantly associated with a reduced risk of overall dementia events (HR 0.54, 95 % CI 0.34-0.85). Restricted cubic spline (RCS) analyses demonstrated significant associations of lower HGS, lower %FM, higher ALST/W ratio, and lower TrFM/ALST ratio with increased risk of overall dementia events. Results remained consistent in sensitivity analyses excluding participants with BMI <21 kg/m2 (n = 67) or %FM below the 15th percentile (n = 135), and after further adjustment for age at highest education level.. Conclusion: This is the first longitudinal study to examine the association between SO and dementia using either the SOGLI or load-capacity models. In this cohort of older women, SO was associated with a lower risk of dementia-related hospitalisation. These findings suggest that the relationship between obesity and dementia risk in late life may differ from current evidence regarding midlife, indicating potential age-specific effects. Further research is needed to clarify the underlying mechanisms and generalisability of these observations to broader populations..
Document Type
Journal Article
Date of Publication
1-1-2026
Volume
56
PubMed ID
41483484
Publication Title
Clinical Nutrition Edinburgh Scotland
Publisher
Elsevier
School
Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences
RAS ID
84567
Funders
National Health and Medical Research Council / Curtin Higher Degree by Research Scholarship / Dementia Centre of Excellence / Curtin enAble Institute Seed Funding / Western Australian Future Health Research / National Heart Foundation Future Leader Fellowship (102817)
Grant Number
NHMRC Numbers : 254627, 303169, 572604, GNT1174886
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
First Page
106542
Comments
Guan, Z., Stephan, B. C., Donini, L. M., Lewis, J. R., Prado, C. M., Prince, R. L., Scott, D., Zhu, K., Sim, M., & Siervo, M. (2025). Association of sarcopenic obesity with dementia risk in a cohort of older women. Clinical Nutrition, 56, 106542. https://doi.org/10.1016/j.clnu.2025.11.026