Submitted:
10 December 2025
Posted:
10 December 2025
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Abstract
Background/Objectives: Sarcopenia, obesity, and sarcopenic obesity (SO) are common in older adults and may be associated with functional limitations in basic (ADL) and instrumental (IADL) activities of daily living. This study aimed to evaluate the association between body composition phenotypes and ADL/IADL limitations among older adults. Methods: A cross-sectional study included 440 community-dwelling adults aged ≥60 years (281 women, 159 men; mean age 74.7 ± 7.8 years). Sarcopenia was diagnosed according to EWGSOP2 criteria, obesity was defined as percent body fat >42% in women and >30% in men, and SO was classified based on the ESPEN/EASO recommendations. Participants without obesity or sarcopenia were categorized as ‘normal’ phenotype. Functional status was evaluated using the Katz and Lawton scales, with limitations defined as ADL ≤5 and IADL ≤26 points, respectively. Multivariate logistic regression analysis was performed to determine factors associated with ADL and IADL limitations. Results: Over half of the participants (57.1%) had abnormal body composition: 31.6% obesity, 11.4% sarcopenia, and 13.2% SO. SO was associated with a nearly threefold higher risk of ADL limitations (OR = 2.86; p = 0.003) and a 3.7-fold higher risk of IADL limitations (OR = 3.68; p < 0.001) compared to the normal phenotype. Sarcopenia was associated with IADL limitations in the unadjusted model (OR = 2.44; p = 0.010). Independent predictors of ADL and IADL limitations included reduced muscle strength, a higher number of chronic diseases, and a worse nutritional status. Conclusions SO was linked to higher risk of both ADL and IADL limitations, while sarcopenia was associated only with IADL deficits. Obesity severity may be relevant, but its impact on daily functioning in older adults requires further study.
