# Relationship between body water distribution and sarcopenia in older adults: a systematic review

## TL;DR

This review finds that water balance in the body is linked to muscle loss in older adults, suggesting it could help assess muscle health.

## Contribution

The study systematically reviews how body water distribution relates to sarcopenia, offering new insights into muscle health markers in aging.

## Key findings

- ECW/TBW and ECW/ICW ratios are associated with sarcopenia and muscle strength in older adults.
- High-quality studies show these water distribution metrics correlate with physical performance and muscle mass loss.
- Imbalances in body water may serve as indicators of muscle health decline in aging populations.

## Abstract

To examine potential relationships between body water distribution, assessed by bioelectrical impedance analysis (BIA), and sarcopenia in older adults.

This systematic review was conducted based on the methodological guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Were Included observational studies exploring the relationship between intracellular water, extracellular water, and total body water – assessed by BIA and sarcopenia. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) assessment tools and guidelines.

Initially, 16,056 articles were identified, and 11 studies were considered eligible for inclusion. Among the studies analyzed, five studies used the ECW/TBW ratio, examining its association with aspects related to sarcopenia, such as muscle strength, loss of muscle mass and physical performance in the older adults. The results indicated that the proportions of extracellular/total body water (ECW/TBW) and extracellular/intracellular water (ECW/ICW) are associated with sarcopenia, muscle strength, loss of muscle mass, and physical performance in the older people. Studies suggest that these relationships may be useful for understanding muscle health and the impact of aging. Most studies presented high methodological quality (above 70%), indicating a low risk of bias.

The findings of this systematic review indicate that imbalances in body water distribution, particularly in the ECW/TBW and ECW/ICW ratios, are consistently associated with sarcopenia, loss of muscle mass, reduced strength, and poorer physical performance in the older adults.