Sarcopenic obesity is associated with impaired physical function and mortality in older patients with heart failure: insight from FRAGILE-HF
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Background: The purpose of this study was to clarify the prevalence, association with frailty and exercise capacity, and prognostic implication of sarcopenic obesity in patients with heart failure. Methods: The present study included 779 older adults hospitalized with heart failure (median age: 81 years; 57.4% men). Sarcopenia was diagnosed based on the guidelines by the Asian Working Group for Sarcopenia. Obesity was defined as the percentage of body fat mass (FM) obtained by bioelectrical impedance analysis. The FM cut-off points for obesity were 38% for women and 27% for men. The primary endpoint was 1-year all-cause death. We assessed the associations of sarcopenic obesity occurrence with the short physical performance battery (SPPB) score and 6-minute walk distance (6MWD). Results: The rates of sarcopenia and obesity were 19.3 and 26.2%, respectively. The patients were classified into the following groups: non-sarcopenia/non-obesity (58.5%), non-sarcopenia/obesity (22.2%), sarcopenia/non-obesity (15.3%), and sarcopenia/obesity (4.0%). The sarcopenia/obesity group had a lower SPPB score and shorter 6MWD, which was independent of age and sex (coefficient, − 0.120; t -value, − 3.74; P < 0.001 and coefficient, − 77.42; t -value, − 3.61; P < 0.001; respectively). Ninety-six patients died during the 1-year follow-up period. In a Cox proportional hazard analysis, sarcopenia and obesity together were an independent prognostic factor even after adjusting for a coexisting prognostic factor (non-sarcopenia/non-obesity vs. sarcopenia/obesity: hazard ratio, 2.48; 95% confidence interval, 1.22–5.04; P = 0.012). Conclusion: Sarcopenic obesity is a risk factor for all-cause death and low physical function in older adults with heart failure. Trial registration: University Hospital Information Network (UMIN-CTR: UMIN000023929 ).
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Sarcopenic obesity is increasingly recognized and may incur a distinct phenotype of low physical functioning and higher mortality, especially in older adults with heart failure.
“In fact, sarcopenic obesity, when lean mass wasting and fat mass expansion occur concurrently, is increasingly recognized and may incur a distinct phenotype of low physical functioning and higher mortality rates, especially in older adults with HF.87,88”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [87]
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- Authors
- Saito, H., Matsue, Y., Kamiya, K., Kagiyama, N., Maeda, D., Endo, Y., Ueno, H., Yoshioka, K., Mizukami, A., Saito, K., Ogasahara, Y., Maekawa, E., Konishi, M., Kitai, T., Iwata, K., Jujo, K., Wada, H., Hiki, M., Dotare, T., Sunayama, T., Kasai, T., Nagamatsu, H., Ozawa, T., Izawa, K., Yamamoto, S., Aizawa, N., Wakaume, K., Oka, K., Momomura, S.-I., & Minamino, T.
- Affiliations
- Juntendo University (JP)
- Kitasato University (JP)
- Osaka Medical and Pharmaceutical University (JP)
- Kameda Medical Center (JP)
- Sakakibara Hospital (JP)
- Yokohama City University Medical Center (JP)
- Kobe City Medical Center General Hospital (JP)
- Jichi Medical University (JP)
- Tokai University (JP)
- Odawara Municipal Hospital (JP)
- Shinshu University Hospital (JP)
- University of the Ryukyus (JP)
- Kitasato University Medical Center (JP)
- Saitama Citizens Medical Center (JP)
- Japan Agency for Medical Research and Development (JP)
- Corresponding author
- Matsue, Yuya
- ORCID
- Saito, Hiroshi
- Matsue, Yuya
- Kamiya, Kentaro
- Kagiyama, Nobuyuki
- Maeda, Daichi
- Yoshioka, Kenji
- Mizukami, Akira
- Saito, Kazuya
- Ogasahara, Yuki
- Maekawa, Emi
- Konishi, Masaaki
- Kitai, Takeshi
- Iwata, Kentaro
- Jujo, Kentaro
- Wada, Hiroshi
- Hiki, Masaru
- Dotare, Taishi
- Kasai, Takatoshi
- Nagamatsu, Hirofumi
- Ozawa, Tetsuya
- Yamamoto, Shuhei
- Wakaume, Kazuki
- Oka, Kazuhiro
- Momomura, Shin-ichi
- Minamino, Tohru
- Venue
- BMC Geriatrics
- Published
- 2022-07-05
- Volume
- 22
- Issue
- 1
- Pages
- 556-556
- ISSN
- 1471-2318 (ISSN-L)
- PMC
- PMC9254413
- OpenAlex
- W4283806639
- Cited by
- 78
- References
- 51
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 38 · 2023: 9
- FWCI
- 10.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Geriatrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Japan Society for the Promotion of Science (18K15862)
- Japan Heart Foundation Research Grant
- Novartis Pharma Research Grants
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- sarcopenic obesity, heart failure, older adults, physical function, all-cause mortality, frailty, exercise capacity, fat mass, sarcopenia, obesity, prognostic factors
- MeSH terms
- Aged, Aged, 80 and over, Female, Heart Failure, Humans, Male, Obesity, Risk Factors, Prevalence, Sarcopenia
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