Dynapenic Abdominal Obesity and Adverse Health Effects in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis

Background/Objectives: Dynapenic abdominal obesity is characterized by reduced muscle strength and abdominal fat accumulation and is associated with adverse health outcomes in older adults. Evidence from multiple studies conducted in different countries regarding these outcomes is inconsistent. This systematic review and meta-analysis evaluated the association between dynapenic abdominal obesity and adverse health outcomes-specifically falls, disability, and mortality-among middle-aged and older adults. Methods: A comprehensive search of Embase, PubMed, MEDLINE, CINAHL, and the Cochrane Library (from inception to December 2024) identified 12 eligible prospective cohort studies. Keywords included "older adults", "elderly", "older people", "dynapenic abdominal obesity", "fall", "disability", and "mortality". A systematic review and meta-analysis was conducted using random-effects models, with subgroup analyses based on measurement methods and geographic regions. Results: Dynapenic abdominal obesity was significantly associated with increased risks of falls (hazard ratio = 1.82, 95% confidence interval: 1.04-3.17) and mortality (hazard ratio = 1.50, 95% confidence interval: 1.14-1.96). The subgroup analysis results indicated variations in outcomes across measurement criteria and countries. Dynapenic abdominal obesity was not significantly associated with disability risk (odds ratio = 0.92, 95% confidence interval: 0.18-4.54). Conclusions: Dynapenic abdominal obesity is associated with significantly increased fall and mortality risks in middle-aged and older adults. These findings underscore the need for targeted assessments and intervention strategies for high-risk groups.