Abstract
OBJECTIVE: Currently, the association of sarcopenic obesity (SO) with cognitive dysfunction and dementia remains unclear. This study aims to investigate their potential association. MATERIALS AND METHODS: PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were systematically searched until 30 December 2024. Observational studies investigating the association of SO with cognitive dysfunction and dementia were included. A random-effects model was applied for meta-analysis. RESULTS: Seventeen studies with 274,996 participants were included, of which 11 were included in quantitative analyses. The pooled odds ratio for cognitive dysfunction in patients with SO versus non-SO was 1.71 (95% CI: 1.39-2.11, p < 0.001, I(2) = 90.7%). Subgroup analyses showed consistent associations across study design, geographic region, cognitive dysfunction subtypes, and obesity criteria. Significant results were also observed in males (OR = 1.80, 95% CI: 1.07-3.03, p = 0.028), general populations (OR = 1.95, 95% CI: 1.50-2.54, p < 0.001), sarcopenia defined by muscle function and/or mass (OR = 1.67, 95% CI: 1.35-2.07, p < 0.001) or muscle function alone (OR = 2.31, 95% CI: 1.14-4.69, p = 0.020), and cognitive assessment via clinical records (OR = 1.68, 95% CI: 1.21-2.33, p = 0.002) or scales (OR = 1.74, 95% CI: 1.37-2.21, p < 0.001). CONCLUSIONS: SO appears associated with cognitive dysfunction. However, due to high heterogeneity, very low certainty of evidence, and potential biases, these results should be interpreted cautiously. Future high-quality prospective studies are needed to validate this conclusion. PROSPERO registration number: CRD420251011745.