Purpose: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the world population. In addition to airflow obstruction, COPD is associated with multiple systemic manifestations, including impaired nutritional status or malnutrition and changes in body composition (low muscle mass, LMM). Poor nutritional status and sarcopenia in subjects with COPD leads to a worse prognosis and increases health-related costs. Data from previous studies indicate that 30–60% of subjects with COPD are malnourished, 20–40% have low muscle mass, and 15–21.6% have sarcopenia. This study aimed to assess the prevalence of malnutrition, sarcopenia, and malnutrition-sarcopenia syndrome in elderly subjects with COPD and investigate the relationship between COPD severity and these conditions.Patients and methods: A cross-sectional study involving 124 patients with stable COPD, aged ≥60, participating in a stationary pulmonary rehabilitation program. Nutritional status was assessed following the Global Leadership Initiative on Malnutrition (GLIM) criteria and sarcopenia with the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. The results of pulmonary function tests and exercise capacity were obtained from the hospital database. Results: 22.6% of participants had malnutrition according to the GLIM criteria. Subjects with malnutrition had lower gait speed (p = 0.0112) and worse results of the Six Minute Walk Test. Sixteen participants (12.9%) had sarcopenia; 12 subjects with sarcopenia had concomitant malnutrition. The prevalence of severe and very severe obstruction (GOLD3/GOLD4) was 91.7%. It was significantly higher in patients with malnutrition-sarcopenia syndrome. Conclusions: Malnutrition was found in nearly one out of four subjects with COPD, while sarcopenia was one out of seven patients. About 10% of our study sample had malnutrition-sarcopenia syndrome. The prevalence of severe and very severe obstruction was significantly higher in patients with malnutrition-sarcopenia syndrome.

Background/Objectives: Sarcopenia, obesity, and sarcopenic obesity (SO) are common in older adults and may be associated with functional limitations in Basic (BADL) and Instrumental (IADL) Activities of Daily Living. This study aimed to evaluate the association between body composition phenotypes and BADL/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. The reference phenotype was ‘non-sarcopenic, non-obese’. Functional status was evaluated using the Katz and Lawton scales, with limitations defined as BADL ≤ 5 and IADL ≤ 26 points, respectively. Multivariate logistic regression was performed to determine associations between body composition phenotypes and BADL/IADL limitations. Results: Over half of the participants (57.1%) had abnormal body composition: 31.6% obesity, 11.4% sarcopenia, and 13.2% SO. Sarcopenic obesity was associated with nearly threefold higher odds of BADL limitations (OR = 2.86; p = 0.003) and 3.7-fold higher odds of IADL limitations (OR = 3.68; p < 0.001), compared to the reference phenotype. Sarcopenia was associated with IADL limitations only in the unadjusted model (OR = 2.44; p = 0.010). Beyond adverse body composition phenotypes, BADL/IADL limitations were also associated with lower muscle strength, multimorbidity, and poorer nutritional status. Conclusions: SO was linked to both BADL and IADL limitations, while sarcopenia was associated only with IADL deficits. Isolated obesity showed no consistent relationship with functional impairment. These findings support prioritizing SO in screening and prevention, although the cross-sectional design precludes causal inference.

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.