Sarcopenic obesity (SO) is a condition combining two important public health issues commonly seen amongst older individuals, obesity and sarcopenia. Depressive symptoms are common among older people, whose population is increasing worldwide. Obesity and sarcopenia alone, are clearly associated with depression while the coexistence of these two conditions (SO) upon depressive disorders is currently unclear. We aimed to systematically review the association between primary SO and depressive disorders.

Searches were run on MEDLINE, EMBASE, PsycINFO, and CINAHL (inception to June 2019). One reviewer screened titles, abstracts, and full-texts, with 10% checked independently by a second reviewer. Cohort and cross-sectional studies were included. Two reviewers independently assessed risk of bias using the Mixed Methods Appraisal Tool. Results were narratively synthesised.

Out of the 7 studies eligible for inclusion, evidence of sarcopenic obesity as a predictor of depressive symptoms was found in two studies. The main observed trend was that diagnosing sarcopenia using muscle strength led to significant associations between sarcopenic obesity and depressive symptoms. Two cross-sectional studies found a significant association between SO and depressive symptoms, whilst three others found no statistically significant associations. All possessed some methodological limitations.

This is the first review to systematically examine a potential relationship between sarcopenic obesity and depressive disorders. Currently, the results are heterogeneous due to the large variability in assessment methods and outcome measurements. Future longitudinal studies would achieve greater confidence in the provisional conclusion that sarcopenic obesity, when measured using muscle strength, is associated with depressive symptoms.