Sarcopenic obesity in older adults: a scoping review of prevalence, assessment tools, associated factors, and interventions.

Background: With the accelerating global population aging, the prevalence of sarcopenic obesity (SO) in older adults has been increasing year by year, which has become a major public health issue that seriously impacts the quality of life and threatens the health status of the older population. Objective: The review aimed to summarize the current status, assessment tools, influencing factors, and intervention measures related to SO among older adults, identify research gaps in the existing literature and provide a reference for future studies. Methods: The review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework. Literature on the current prevalence, assessment tools, influencing factors, and interventions for older adults with SO was retrieved from the following databases: China National Knowledge Infrastructure (CNKI), Wanfang Database, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Library. The search timeframe was restricted from database inception to October 2025. Two researchers independently screened the research literature, extracted data, and summarized findings. Results: Forty-five studies were included, which were published between 2016 and 2025, with a marked increase in publications from 2021 to 2025. The prevalence of SO among older adults ranged from 2.52 to 34.62%, with notable variations across studies. Assessment tools were diverse, but a standardized evaluation framework was lacking. Influencing factors were categorized into four groups: sociodemographic factors, disease-related factors, psychosocial and behavioral factors, and nutritional factors. Intervention measures included exercise interventions, nutritional interventions, and multidomain interventions. Conclusion: The prevalence of SO among older adults varies considerably, and existing assessment tools lack a standardized framework and diagnostic thresholds that are not population-specific. Future efforts should integrate the characteristics of sarcopenia and obesity to develop predictive assessment tools specifically tailored for older adults with SO, while also focusing on the factors influencing SO to further refine intervention measures, aiming to slow disease progression and promote healthy aging.