Hsiao-Chi Tsai

Background: Dynapenic abdominal obesity (DAO), the coexistence of low muscle strength and abdominal obesity, may accelerate disability. However, its longitudinal association with disability remains unclear. In this study, we examined the relationship between DAO and disability in middle-aged and older adults. Methods: A systematic review and random-effects meta-analysis of prospective cohort studies was conducted to examine longitudinal associations following the PRISMA 2020 guidelines (PROSPERO: CRD42024609352). Comprehensive database searches were conducted in PubMed, Embase, MEDLINE (Ovid), CINAHL (EBSCOhost), and the Cochrane Library from database inception through 31 January 2025. To ensure that the review reflected the most recent evidence prior to manuscript submission, an updated search using the same search strategy and eligibility criteria was conducted on 31 May 2026. When multiple effect estimates were reported, the most fully adjusted estimates were selected. Because odds ratios (ORs) and hazard ratios (HRs) are different effect measures and are not directly comparable, they were analyzed separately. A random-effects model was used for quantitative synthesis. Results: Five cohort studies (n = 33,670; mean follow-up: 5.3 years) were included. Of these, four studies reported adjusted ORs and one reported an HR. DAO was associated with significantly higher odds of disability (pooled OR = 2.13, 95% CI: 1.74–2.60, I² = 0%). Subgroup analyses demonstrated significant associations across predominant population types and age groups, with ORs ranging from 2.09 to 2.18. Conclusions: DAO is associated with increased odds of future disability across population types and age groups. These findings highlight the importance of early identification of DAO and suggest that interventions targeting muscle strength and abdominal obesity represent promising strategies for disability prevention; however, their effectiveness should be confirmed in future prospective intervention studies.

Background: Dynapenic abdominal obesity (DAO) is known to increase the risk of physical decline and falls in older adults. However, it is still unclear how different factors—such as sleep quality, nutrition, social participation, cognition, and mood—work together to influence this risk. The aim of this study was to identify factors associated with fall risk—specifically sleep quality, nutritional status, community participation, cognitive function, and depressive symptoms—among community-dwelling older adults with dynapenic abdominal obesity. Methods: We conducted a cross-sectional study with 180 adults aged 65 and above. Validated questionnaires were used to measure sleep quality, nutritional status, community participation, cognitive function, depressive symptoms, and fall risk. Data were analyzed using t-tests, ANOVA, and logistic regression. Results: Although poor sleep showed differences in the univariate analysis, it did not remain significant in the multivariable model. Older adults with malnutrition, lower community participation, cognitive decline, or depressive symptoms were more likely to have a higher fall risk. Logistic regression further indicated that nutritional status (OR = 7.03, p = .013), community participation (OR = 0.91, p = .031), cognition (OR = 6.18, p = .028), and depressive symptoms (OR = 9.23, p = .008) were significant predictors. Conclusion: Fall risk in older adults with DAO is influenced by a mix of physical, psychological, and social factors. Community nurses and other health professionals should routinely check nutrition, cognitive function, and emotional health to identify those at higher risk early and provide more holistic, preventive care that supports safe aging.

Background: Dynapenia refers to the age-related decline in muscle strength that occurs even when muscle mass is preserved. It has become an important issue in older adults because reduced strength is strongly linked to many negative health outcomes. When dynapenia occurs together with obesity—referred to as dynapenic obesity or dynapenic abdominal obesity—the risks, including mortality, falls, and the development of multiple chronic conditions, appear to increase even further. This umbrella review aimed to bring together and summarize existing systematic reviews and meta-analyses that examined how dynapenia and its obesity-related subtypes are associated with mortality, falls, and multimorbidity among community-dwelling older adults. Methods: Following PRISMA 2020 and JBI guidelines, six major databases and search engines (PubMed, Embase, Cochrane Library, Scopus, CINAHL, and Airiti Library) were searched from their inception to October 2025. Systematic reviews and meta-analyses involving adults aged 60 years and older and reporting quantitative results on the relationships between dynapenia-related conditions and adverse health outcomes were included. The methodological quality of each review was evaluated using AMSTAR 2, and the certainty of evidence was assessed with the GRADE approach. This umbrella review followed the PRIOR framework and was reported according to PRISMA 2020. The protocol for this review was registered in PROSPERO (ID: CRD 42023415232). Results: A total of four systematic reviews and meta-analyses were included, covering more than 73,000 community-dwelling older adults. The pooled data showed that dynapenic obesity significantly increased the risk of all-cause mortality, with hazard ratios ranging from 1.50 (95% CI 1.14–1.96) to 1.73 (95% CI 1.38–2.16). Dynapenic abdominal obesity was also strongly linked to falls, with pooled estimates ranging from HR = 1.82 (95% CI 1.04–3.17) to RR = 6.91 (95% CI 5.42–8.80). For multimorbidity, older adults with dynapenia had 1.38 times higher odds of having two or more chronic diseases than those without dynapenia (OR = 1.38, 95% CI 1.10–1.72). Based on the GRADE evaluation, the certainty of evidence was moderate for mortality and falls and low for multimorbidity. Conclusions: Overall, the findings indicate that dynapenia and its obesity-related forms meaningfully increase the risks of mortality, falls, and multimorbidity among community-dwelling older adults. Importantly, these results position dynapenia not merely as a musculoskeletal condition, but as a clinically relevant marker of aging-related vulnerability. This underscores the need for early screening of muscle strength alongside obesity-related indicators, as well as the development of integrated preventive strategies that combine strength-oriented interventions with obesity management in older populations.