BACKGROUND:
Obesity, dynapenia, and sarcopenia are risk factors for cognitive decline. With the aging process, the combination of these conditions can increase the risks to the cognitive health of older adults. The aim of this study was to investigate the association between dynapenic obesity and sarcopenic obesity with cognitive decline in older adults.

METHODS:
Cross-sectional study using data from the second wave (2019 – 2021) of the Longitudinal Study of the Health of Brazilian Aged Elderly (ELSI-Brazil) with older adults ≥ 50 years. Obesity was defined as a Body Mass Index (BMI) ≥26.6 kg/m² for females and ≥25 for males. Dynapenic obesity was defined by low handgrip strength (HGS) + obesity, and sarcopenic obesity was assessed as low HGS and poor physical performance by the three-meter walk test + obesity. Cognitive decline was measured by global z-score of the cognitive domains assessed. Analyses were performed using Poisson regression, with crude and adjusted Prevalence Ratios (PR) for age, per capita income, marital status, and education.

RESULTS:
In the sample of 9,856 individuals, the prevalence of dynapenic obesity was 18.73% and sarcopenic obesity was 16.71%. In the bivariate analysis, dynapenic obesity showed a significant association with cognitive decline (PR: 1.83; 95% CI: 1.41 – 2.38), as did sarcopenic obesity, which was associated with cognitive decline (PR: 2.00; 95% CI: 1.52 – 2.65). After adjustments, the associations remained significant: dynapenic obesity with cognitive decline (PR: 1.38; 95% CI: 1.08–1.76), and sarcopenic obesity with cognitive decline (PR: 1.44; 95% CI: 1.10–1.89), all with p<0.001.

CONCLUSIONS:
The findings indicate that dynapenic obesity and sarcopenic obesity are associated with cognitive decline, reinforcing their role as important risk markers in the older adults population.