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Jamka M, Chrobot M, Jaworska N, Brylak J, Makarewicz-Bukowska A, Popek J, Janicka A, Walkowiak J. Comparison of Eating Habits, Body Composition and Densitometric Parameters between Subjects with Normal Cognitive Function and Mild Cognitive Impairment: An Observational Study. Nutrients 2024; 16:644. [PMID: 38474772 PMCID: PMC10934958 DOI: 10.3390/nu16050644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
The role of nutrition in the ageing process of the brain is pivotal. Therefore, the study aimed to compare eating habits, body composition and densitometric parameters between subjects with normal cognitive function (NCF) and mild cognitive impairment (MCI). A total of 95 subjects with NCF (74% of women) and 95 individuals with MCI (77% of women) aged 50-70 years were studied. Densitometric parameters were evaluated using dual-energy X-ray absorptiometry methods. Eating habits were assessed using the food frequency questionnaire and 3-day diary records, and advanced glycation end products (AGEs) intake was calculated. Significant differences between groups were detected for the %fat in the right arm (NCF vs. MCI: 38.4 (30.4-46.8) vs. 43.5 (35.5-49.2)%, p = 0.0407). Moreover, the MCI group had a significantly lower intake of calcium (p = 0.0010), phosphor (p = 0.0411), vitamins B2 (p = 0.0138) and B12 (p = 0.0024) compared to the NCF group, with both groups also differing in the frequency of butter (p = 0.0191) and fermented milk beverages (p = 0.0398) intake. Analysis restricted to women showed significant differences between groups in right arm %fat, VAT mass, calcium, vitamins B2, B12, butter and fermented milk products intake, while in men, differences were detected in the intake of calcium, iodine, vitamin B1, water and AGEs. In conclusion, subjects with NCF and MCI have comparable densitometric variables but differ significantly in some body composition parameters and the intake of some food groups and nutrients.
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Affiliation(s)
| | | | | | | | | | | | | | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna Str. 27/33, 60-572 Poznań, Poland; (M.J.); (M.C.); (N.J.); (J.B.); (A.M.-B.); (J.P.); (A.J.)
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Peng TC, Chiou JM, Chen TF, Chen YC, Chen JH. Grip Strength and Sarcopenia Predict 2-Year Cognitive Impairment in Community-Dwelling Older Adults. J Am Med Dir Assoc 2023; 24:292-298.e1. [PMID: 36435272 DOI: 10.1016/j.jamda.2022.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Using the Asian Working Group for Sarcopenia (AWGS2019) and the European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, this study examined associations of sarcopenia and its components with specific domains of cognitive impairment over time. DESIGN A prospective cohort study with a 2-year follow-up. SETTING AND PARTICIPANTS This study is part of the Taiwan Initiatives for Geriatric Epidemiological Research (TIGER), which recruited participants aged 65 years old who attended the senior health checkup program at National Taiwan University Hospital (NTUH). METHODS Grip strength was measured using a handgrip dynamometer. Walking speed (m/s) was measured as the time required to walk 8 feet. Muscle mass was measured by performing a bioelectrical impedance analysis. Global cognition (assessed using the Taiwanese version of the Montreal Cognitive Assessment) and 4 cognitive domains (memory, executive function, verbal fluency, and attention) were assessed over time. Associations of sarcopenia and its components with cognitive impairment were evaluated after stratification by sex using generalized linear mixed models adjusted for essential covariates for cognitive impairment. RESULTS Compared with robust women, those with severe sarcopenia were more likely to have a global cognitive impairment over time (β = -0.87, P = .03 based on AWGS2019 criteria and β = -1.07, P = .02 based on the EWGSOP2 criteria). Among men, low grip strength was associated with poor scores on measures of global cognition (β = -0.80, P = .03), executive function (β = -0.35, P = .001), verbal fluency (β = -0.31, P = .02), and attention (β = -0.34, P = .008) over time. CONCLUSIONS AND IMPLICATIONS Severe sarcopenia predicted global and specific domains of cognitive impairment in older adults. Poor grip strength predicted cognitive impairment in men but not in women. A screen for sarcopenia severity and low muscle strength may be used to identify the risk of cognitive impairment.
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Affiliation(s)
- Tao-Chun Peng
- Division of Family Medicine and Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jeng-Min Chiou
- Institute of Statistical Science, Academia Sinica, Nankang District, Taipei, Taiwan; Institute of Statistics and Data Science, National Taiwan University, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Ching Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Jen-Hau Chen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Uchida K, Sugimoto T, Tange C, Nishita Y, Shimokata H, Saji N, Kuroda Y, Matsumoto N, Kishino Y, Ono R, Akisue T, Otsuka R, Sakurai T. Association between Reduction of Muscle Mass and Faster Declines in Global Cognition among Older People: A 4-Year Prospective Cohort Study. J Nutr Health Aging 2023; 27:932-939. [PMID: 37997712 DOI: 10.1007/s12603-023-2007-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/17/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES A few studies reported that both decrease and increase in body mass index (BMI) were associated with the development of dementia in later life. However, it is unclear what changes in body composition are associated with cognitive decline. This study investigated the longitudinal influences of changes in body composition on cognitive function among community-dwelling adults. DESIGN, SETTING AND PARTICIPANTS This longitudinal study included older adults aged ≥60 years without cognitive impairment who participated in National Institute for Longevity Sciences - Longitudinal Study of Aging. MEASUREMENTS Cognitive function was assessed using the MMSE. Body composition was measured by a dual-energy X-ray absorptiometry system. Then, BMI, fat mass index (FMI), fat-free mass index (FFMI), and muscle mass index (MMI) were calculated. The changes in body composition over 6 years (second wave to fifth wave) were calculated, and three groups were created: decreased group, decrease of >5%; stable group, change within 5%, and increased group, increase of >5%. In statistical analysis, a linear mixed model was applied by sex to investigate the influences of body composition changes on cognitive function over 4 years (fifth wave to seventh wave). RESULTS This study analyzed 515 participants (mean age, 67.05 years; 53.4% men). Men with decreased group in FFMI and MMI exhibited faster declines in MMSE scores than those with stable group (β [95% CI]: FFMI, -0.293 [-0.719 to -0.020]; MMI, -0.472 [-0.884 to -0.059]). In women, there was no significant association between body composition changes and cognitive functions. CONCLUSIONS Decrease in fat-free mass and muscle mass is associated with faster cognitive declines in men. These results suggest the importance of continuous monitoring of muscle mass to prevent cognitive decline in later life.
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Affiliation(s)
- K Uchida
- Takashi Sakurai, 7-430 Morioka, Obu, Aichi 474-8511, Japan, TEL: +81-562-46-2311, FAX: +81-562-46-8394, E-mail:
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Bian D, Li X, Xiao Y, Song K, Wang L, Shen J, Aimaiti M, Ma X, Shi C, Li G. Relationship between Social Support, Sarcopenia, and Cognitive Impairment in Chinese Community-Dwelling Older Adults. J Nutr Health Aging 2023; 27:726-733. [PMID: 37754212 DOI: 10.1007/s12603-023-1973-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/24/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Cognitive impairment and sarcopenia have become important challenges for the growing aging population. Social support has been shown to protect against cognitive impairment, but its impact on sarcopenia remains unknown. The purpose of this study was to explore the correlation between social support, sarcopenia, and cognitive impairment in Chinese older adults. METHOD A multi-stage whole group sampling method was used to conduct a cross-sectional survey of 720 community-dwelling older people in Shanghai. The definition of sarcopenia was in accordance with the criteria of the Asian Working Group for Sarcopenia (AWGS) 2019. Cognitive impairment was evaluated using a computerized neuropsychological assessment device that had been previously validated. Social support was assessed using the Social Support Rate Scale. Logistic regression analyses were conducted to explore the relationship between social support cognitive impairment and sarcopenia, fully adjusting for all potential confounding factors. RESULTS Our study found that 230 (31.94%) of the participants had cognitive impairment and 97 (13.47%) of the participants had sarcopenia. The mean social support score was 35.10 ± 7.54. Besides, the results showed that cognitive impairment was associated with sarcopenia (OR:1.650, 95% CI: 1.048, 2.596, P=0.030) after adjusting for confounding factors. Older adults with high level social support had the lowest risk of cognitive impairment (OR: 0.297, 95% CI: 0.115, 0.680, P=0.021) and sarcopenia (OR: 0.113, 95% CI: 0.031, 0.407, P=0.001), respectively. CONCLUSION Our analysis revealed that high level social support was negatively associated with sarcopenia and cognitive impairment. These findings provide strong support for the health promotion effect of social networks against sarcopenia and cognitive impairment in Chinese community-dwelling older adults, with important implications for healthcare policy makers.
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Affiliation(s)
- D Bian
- C. Shi, Center for Health Technology Assessment, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China, ; G. Li, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
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Kim S, Won CW. Sex-different changes of body composition in aging: a systemic review. Arch Gerontol Geriatr 2022; 102:104711. [PMID: 35588612 DOI: 10.1016/j.archger.2022.104711] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Aging causes changes in body composition, in which differences in the distribution and amount of fat and muscle tissue affect the development of various diseases according to sex. We conducted a systemic review of the literature and examined the relationship between body composition differences and related health conditions or diseases in older men and women. METHODS Three different electronic databases (MEDLINE, Web of Science, and Embase) were used to find articles from 2000 until March 2022. Information on the study design characteristics, setting, measure of body composition, and health outcomes was extracted. RESULTS A total of 217 articles were retrieved, and 28 studies met the inclusion criteria. The included studies showed that older men have larger skeletal muscle mass (sMM) than women, while older women have larger fat mass (FM) than men. sMM has a favorable effect on physical performance, bone density, metabolism, cognitive function, and mortality in both men and women; however, the effects of sMM in women are less significant and even negligible compared to those in men. FM is significantly unfavorable for physical performance in women but sometimes favorable or unfavorable for glucose level and cognitive and lung function according to location. FM in men is usually less important for function, bone density, glucose level, and cognitive function than in women. CONCLUSION Changes in muscle and fat distribution according to aging and their correlation with health outcomes differ according to sex. Muscle mass may not always be favorable, and fat mass may not always be unfavorable in older adults.
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Affiliation(s)
- Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Association of life course adiposity with risk of incident dementia: a prospective cohort study of 322,336 participants. Mol Psychiatry 2022; 27:3385-3395. [PMID: 35538193 DOI: 10.1038/s41380-022-01604-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 01/08/2023]
Abstract
Cohort studies report inconsistent associations between body mass index (BMI) and all-cause incident dementia. Furthermore, evidence on fat distribution and body composition measures are scarce and few studies estimated the association between early life adiposity and dementia risk. Here, we included 322,336 participants from UK biobank to investigate the longitudinal association between life course adiposity and risk of all-cause incident dementia and to explore the underlying mechanisms driven by metabolites, inflammatory cells and brain structures. Among the 322,336 individuals (mean (SD) age, 62.24 (5.41) years; 53.9% women) in the study, during a median 8.74 years of follow-up, 5083 all-cause incident dementia events occurred. The risk of dementia was 22% higher with plumper childhood body size (p < 0.001). A strong U-shaped association was observed between adult BMI and dementia. More fat and less fat-free mass distribution on arms were associated with a higher risk of dementia. Interestingly, similar U-shaped associations were found between BMI and four metabolites (i.e., 3-hydroxybutrate, acetone, citrate and polyunsaturated fatty acids), four inflammatory cells (i.e., neutrophil, lymphocyte, monocyte and leukocyte) and abnormalities in brain structure that were also related to dementia. The findings that adiposity is associated with metabolites, inflammatory cells and abnormalities in brain structure that were related to dementia risk might provide clues to underlying biological mechanisms. Interventions to prevent dementia should begin early in life and include not only BMI control but fat distribution and body composition.
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Salinas‐Rodríguez A, Palazuelos‐González R, Rivera‐Almaraz A, Manrique‐Espinoza B. Longitudinal association of sarcopenia and mild cognitive impairment among older Mexican adults. J Cachexia Sarcopenia Muscle 2021; 12:1848-1859. [PMID: 34535964 PMCID: PMC8718052 DOI: 10.1002/jcsm.12787] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/25/2021] [Accepted: 08/04/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Recent evidence from cross-sectional and longitudinal studies supports the hypothesis that sarcopenia is associated with worsening cognitive function. However, primary evidence largely comes from high-income countries, whereas in low- and middle-income countries, this association has been underexplored. This study aimed to estimate the longitudinal association between sarcopenia and mild cognitive impairment in a sample of older Mexican adults. METHODS Data come from the three waves of the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE) in Mexico (2009, 2014, 2017). Four hundred ninety-six older adults, aged ≥50, were included. Sarcopenia was defined as having low muscle quantity and either/both slow gait speed and weak handgrip strength. Mild cognitive impairment was determined based on the recommendations of the National Institute on Aging-Alzheimer's Association. Cognitive function was evaluated by a composite cognitive score of five different cognitive tests: immediate and delayed recall, forward and backward digit span and semantic verbal fluency. Three-level mixed-effects models (logistic and linear) were used to estimate the longitudinal associations between sarcopenia, mild cognitive impairment and cognitive function. RESULTS The prevalence of mild cognitive impairment (8.9%, 12.9%, 16.0%) and sarcopenia (10.5%, 20.7%, 23.3%) showed a significant temporal increase for Waves 1, 2 and 3 (P-value < 0.01, respectively). The presence of sarcopenia was significantly associated with mild cognitive impairment (OR = 1.74; CI95% 1.02, 2.96; P = 0.04) and worse cognitive function (β = -0.57; CI95% -0.93, -0.21; P < 0.01). We observed significant associations between sarcopenia and immediate verbal recall (β = -0.14; CI95% -0.28, -0.01; P = 0.04), delayed verbal recall (β = -0.12; CI95% -0.23, -0.01; P = 0.03) and semantic verbal fluency (β = -0.17; CI95% -0.28, -0.05; P = 0.01). The prevalence of mild cognitive impairment increased at an annual rate of 0.8% for non-sarcopenic older adults, but nearly 1.5% for sarcopenic adults. CONCLUSIONS Significant longitudinal associations were observed between sarcopenia, mild cognitive impairment and cognitive function among older Mexican adults. Public health strategies, including policy research and clinical interventions, must be implemented in low- and middle-income countries in order to reduce or delay the onset of sarcopenia and thus improve population-level cognitive health among older adults.
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Affiliation(s)
- Aarón Salinas‐Rodríguez
- Center for Evaluation and Surveys ResearchNational Institute of Public HealthCuernavacaMexico
| | | | - Ana Rivera‐Almaraz
- Center for Evaluation and Surveys ResearchNational Institute of Public HealthCuernavacaMexico
| | - Betty Manrique‐Espinoza
- Center for Evaluation and Surveys ResearchNational Institute of Public HealthCuernavacaMexico
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Bai A, Xu W, Sun J, Liu J, Deng X, Wu L, Zou X, Zuo J, Zou L, Liu Y, Xie H, Zhang X, Fan L, Hu Y. Associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old. BMC Geriatr 2021; 21:292. [PMID: 33957882 PMCID: PMC8101237 DOI: 10.1186/s12877-021-02190-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to investigate the associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old (over 80 years old) in China. METHODS Sarcopenia was diagnosed by the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). Logistic and linear regression models were used to explore the associations of sarcopenia and its defining components with risk of mild cognitive impairment (MCI), and performance on multiple cognitive domains among 428 adults aged 80 years and older. RESULTS The overall prevalence of sarcopenia was 35.5%, with 40.34% for men and 32.14% for women. The prevalence of MCI was higher among sarcopenic oldest old than non-sarcopenic oldest old (28.95% vs. 17.39%, p = 0.005). Multivariate logistic regression analyses showed that sarcopenia [odds ratio (OR) = 1.86, 95% confidence interval (CI): 1.04-3.33], low handgrip strength (HS) [OR = 2.33, 95% CI: 1.40-3.87] and slow gait speed (GS) [OR = 2.31, 95% CI: 1.13-4.72] were significantly and independently associated with risk of MCI. Multivariate linear regression analyses showed that low HS was associated with worse performance in global cognitive function, visuospatial and executive function, naming and delayed recall. CONCLUSIONS Sarcopenia, low HS and low GS was significantly associated with MCI in community-dwelling oldest old. The associations between sarcopenia and its defining components with different cognitive subdomains could be further explored in the future.
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Affiliation(s)
- Anying Bai
- Peking University Health Science Centre, School of Public Health, Beijing, China.,Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Weihao Xu
- Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jing Sun
- Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Juan Liu
- Geriatric Department of Beijing North Hospital Of Ordnance Industry, Beijing, China
| | - Xinli Deng
- Laboratory Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Linna Wu
- Geriatric Emergency Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiao Zou
- Geriatric Cardiology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Jing Zuo
- Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lin Zou
- Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yunxia Liu
- Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Hengge Xie
- Neurology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiaohong Zhang
- Neurology Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Li Fan
- Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yixin Hu
- Geriatric Health Care Department of The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China.
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Cui M, Zhang S, Liu Y, Gang X, Wang G. Grip Strength and the Risk of Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis of Longitudinal Cohort Studies. Front Aging Neurosci 2021; 13:625551. [PMID: 33613270 PMCID: PMC7890203 DOI: 10.3389/fnagi.2021.625551] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/04/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose: Loss of grip strength and cognitive impairment are prevalent in the elderly, and they may share the pathogenesis in common. Several original studies have investigated the association between them, but the results remained controversial. In this systematic review and meta-analysis, we aimed to quantitatively determine the relationship between baseline grip strength and the risk of cognitive impairment and provide evidence for clinical work. Methods: We performed a systematic review using PubMed, EMBASE, Cochrane, and Web of Science up to March 23, 2020, and focused on the association between baseline grip strength and onset of cognitive impairment. Next, we conducted a meta-analysis using a hazard ratio (HR) and 95% confidence interval (CI) as effect measures. Heterogeneity between the studies was examined using I2 and p-value. Sensitivity analyses and subgroup analyses were also performed, and publication bias was assessed by Begg's and Egger's tests. Results: Fifteen studies were included in this systematic review. After sensitivity analyses, poorer grip strength was associated with more risk of cognitive decline and dementia (HR = 1.99, 95%CI: 1.71–2.32; HR = 1.54, 95%CI: 1.32–1.79, respectively). Furthermore, subgroup analysis indicated that people with poorer strength had more risk of Alzheimer's disease (AD) and non-AD dementia (HR = 1.41, 95%CI: 1.09–1.81; HR = 1.45, 95%CI: 1.10–1.91, respectively). Conclusions: Lower grip strength is associated with more risk of onset of cognitive decline and dementia despite of subtype of dementia. We should be alert for the individuals with poor grip strength and identify cognitive dysfunction early.
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Affiliation(s)
- Mengzhao Cui
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Siwen Zhang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Yujia Liu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China
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Huang ST, Tange C, Otsuka R, Nishita Y, Peng LN, Hsiao FY, Tomida M, Shimokata H, Arai H, Chen LK. Subtypes of physical frailty and their long-term outcomes: a longitudinal cohort study. J Cachexia Sarcopenia Muscle 2020; 11:1223-1231. [PMID: 32558267 PMCID: PMC7567152 DOI: 10.1002/jcsm.12577] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/26/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Components of physical frailty cluster into subtypes, but it remains unknown how these might be associated with age-related functional declines and multimorbidities. This study aims to investigated associations of physical frailty subtypes with functional declines and multimorbidity in a 10 year longitudinal cohort survey. METHODS Complementary longitudinal cohort study used group-based multitrajectory modelling to verify whether frailty subtypes discovered in Taiwan are presented in another aging cohort, then investigated associations of these subtypes with cognitive decline and multimorbidity. Participants aged ≥50 years were recruited from the third to sixth waves (May 2002 to July 2010) of the National Institute for Longevity Sciences-Longitudinal Study of Aging, in Japan. People with incomplete data, pre-frail/frail status before their index wave, and those with incomplete data or who died during follow-up, were excluded. Group-based trajectory analysis denoted five established physical frailty criteria as time-varying binary variables in each wave during follow-up. Incident frailty was classified as mobility subtype (weakness/slowness), non-mobility subtype (weight loss/exhaustion), or low physical activity subtype. General linear modelling investigated associations of these frailty subtypes with activities of daily living, digit symbol substitution test (DSST) and Charlson Comorbidity Index (CCI) at 2 year follow-up. RESULTS We identified four longitudinal trajectories of physical frailty, which corroborated the distinct subtypes we discovered previously. Among 940 eligible participants, 38.0% were robust, 18.4% had mobility subtype frailty, 20.7% non-mobility subtype, and 20.1% low physical activity subtype. People with mobility subtype frailty were older than those with other frailty subtypes or robust status and had higher prevalence of hypertension, diabetes, and heart failure. In the multivariable-adjusted general linear models, mobility-subtype frailty was associated with a significantly lower DSST score (point estimate -2.28, P = 0.03) and higher CCI (point estimate 0.82, P < 0.01) than the other groups. CONCLUSIONS Mobility-subtype frailty was associated with functional declines and progression of multimorbidity; the long-term effects of physical frailty subtypes deserve further investigation.
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Affiliation(s)
- Shih-Tsung Huang
- Graduate Institute of Clinical Pharmacy, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chikako Tange
- Section of NILS-LSA, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Rei Otsuka
- Section of NILS-LSA, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Li-Ning Peng
- Department of Geriatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- Graduate Institute of Clinical Pharmacy, National Taiwan University College of Medicine, Taipei, Taiwan.,School of Pharmacy, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Makiko Tomida
- Section of NILS-LSA, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroshi Shimokata
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| | - Liang-Kung Chen
- Department of Geriatrics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
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Sex-moderated association between body composition and cognition in older adults. Exp Gerontol 2020; 138:111002. [PMID: 32561399 DOI: 10.1016/j.exger.2020.111002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/26/2020] [Accepted: 06/08/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Some studies have reported an association between body composition and cognition in older adults, but underlying mechanisms and physiological factors remain poorly understood. Moreover, sex-related differences in metabolic health and age-related cognitive decline have gained major interest lately. The present study investigated the potential moderating effect of sex on the relationship between body composition and cognition in older adults. METHODS Global cognition, assessed by the Montreal Cognitive Assessment (MoCA), and body composition, measured using dual-energy x-ray absorptiometry (DXA), were analyzed in 155 women and 65 men aged 60 years old or more. Moderation analyses were computed to determine if sex moderates the effect of the different body composition parameters on the MoCA while controlling for the body mass index and the level of education of the participants. RESULTS Sex moderated the association between total lean mass, trunk lean mass, arms lean mass, and the MoCA score. These body composition parameters were positively associated with cognition only in men. Fat mass was not associated with cognition in any sex. CONCLUSION Overall, higher lean mass and in particular trunk and arms lean mass was associated with higher cognitive abilities in older men. Longitudinal studies or intervention studies are needed to further identify physiological mechanisms that sustain the relationship between lean mass and cognition.
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Association between Lower Extremity Skeletal Muscle Mass and Impaired Cognitive Function in Type 2 Diabetes. Sci Rep 2020; 10:2956. [PMID: 32076075 PMCID: PMC7031513 DOI: 10.1038/s41598-020-59914-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/04/2020] [Indexed: 01/28/2023] Open
Abstract
Lower extremity skeletal muscle mass (LESM) in Type 2 Diabetes (T2D) has been linked to adverse clinical events, but it is not known whether it is associated with cognitive difficulties. We conducted a cross-sectional study on 1,235 people (mean age 61.4 ± 8.0 years) with T2D under primary and secondary care in Singapore. Bioelectrical impedance analyses (BIA) measures of upper extremity skeletal muscle mass (UESM), LESM and appendicular skeletal muscle index (SMI) were related to the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) measures of cognition, in multiple linear regression. In multivariable models, tertile 1 LESM (b = −2.62 (−3.92 to −1.32)) and tertile 2 LESM (b = −1.73 (−2.73 to −0.73)), referenced to tertile 3) were significantly associated with decreased RBANS total score. Significant associations of LESM with cognitive domain performances were observed for tertile 1 (b = −3.75 (−5.98 to −1.52)) and tertile 2 (b = −1.98 (−3.69 to −0.27)) with immediate memory, and for tertile 1 (b = −3.05 (−4.86 to −1.24)) and tertile 2 (b = −1.87 (−3.25 to −0.48)) with delayed memory, and for tertile 1 (b = −2.99 (−5.30 to −0.68)) with visuospatial/constructional ability. Tertile 1 SMI (b = −1.94 (−3.79 to −0.08) and tertile 2 SMI (b = −1.75 (−3.14 to −0.37)) were also associated with delayed memory. There were no associations between UESM with cognitive performance. Lower LESM may be a useful marker of possible co-occuring cognitive dysfunction.
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Peng TC, Chen WL, Wu LW, Chang YW, Kao TW. Sarcopenia and cognitive impairment: A systematic review and meta-analysis. Clin Nutr 2019; 39:2695-2701. [PMID: 31917049 DOI: 10.1016/j.clnu.2019.12.014] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/20/2019] [Accepted: 12/08/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sarcopenia and cognitive impairment are two of the most prevalent causes of disability in the aging population. Despite the vast amount of research that has been done to quantify the association between these two conditions, extensive systematic reviews and meta-analyses remain limited. METHODS We performed a systematic review using the PubMed, EMBASE, Scopus, and Google Scholar databases. Sarcopenia was defined as the loss of skeletal muscle mass and muscle function, as measured by muscle strength or performance. Cognitive impairment was diagnosed by validated cognitive or neuropsychological tests. RESULTS We identified 303 potentially relevant articles in the initial search. Observational studies quantifying a relationship between sarcopenia and cognitive impairment were selected. Information was extracted from 15 studies, and random-effects models were used for the meta-analysis. The pooled odds ratios for cognitive impairment for patients with sarcopenia compared with patients without sarcopenia were 2.85 (95% confidence interval: 2.19-3.72) in the unadjusted analysis and 2.25 (95% confidence interval: 1.70-2.97) in the adjusted meta-analysis. These results remained constant in subgroup analyses by study population, study region, the definition of sarcopenia, and cognitive impairment. Although half of the studies (8 out of 15) were of fair quality, we conducted a sensitivity analysis to exclude studies with fair quality and obtained similar results. CONCLUSIONS Sarcopenia is associated with an increased risk of cognitive impairment independent of study population, the definition of sarcopenia, and cognitive impairment. This suggests the importance of the early recognition of sarcopenia for the prevention of cognitive impairment in clinical practice.
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Affiliation(s)
- Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yaw-Wen Chang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taiwan.
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Zengarini E, Giacconi R, Mancinelli L, Riccardi GR, Castellani D, Vetrano DL, Onder G, Volpato S, Ruggiero C, Fabbietti P, Cherubini A, Guarasci F, Corsonello A, Lattanzio F. Prognosis and Interplay of Cognitive Impairment and Sarcopenia in Older Adults Discharged from Acute Care Hospitals. J Clin Med 2019; 8:jcm8101693. [PMID: 31619001 PMCID: PMC6832971 DOI: 10.3390/jcm8101693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 12/25/2022] Open
Abstract
Sarcopenia and cognitive impairment are associated with an increased risk of negative outcomes, but their prognostic interplay has not been investigated so far. We aimed to investigate the prognostic interaction of sarcopenia and cognitive impairment concerning 12-month mortality among older patients discharged from acute care wards in Italy. Our series consisted of 624 patients (age = 80.1 ± 7.0 years, 56.1% women) enrolled in a prospective observational study. Sarcopenia was defined following the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. Cognitive impairment was defined as age- and education-adjusted Mini-Mental State Examination (MMSE) score < 24 or recorded diagnosis of dementia. The study outcome was all-cause mortality during 12-month follow-up. The combination of sarcopenia and cognitive ability was tested against participants with intact cognitive ability and without sarcopenia. Overall, 159 patients (25.5%) were identified as having sarcopenia, and 323 (51.8%) were cognitively impaired. During the follow-up, 79 patients (12.7%) died. After adjusting for potential confounders, the combination of sarcopenia and cognitive impairment has been found associated with increased mortality (HR = 2.12, 95% CI = 1.05-4.13). Such association was also confirmed after excluding patients with dementia (HR = 2.13, 95% CI = 1.06-4.17), underweight (HR = 2.18, 95% CI = 1.03-3.91), high comorbidity burden (HR = 2.63, 95% CI = 1.09-6.32), and severe disability (HR = 2.88, 95% CI = 1.10-5.73). The co-occurrence of sarcopenia and cognitive impairment may predict 1-year mortality in older patients discharged from acute care hospitals.
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Affiliation(s)
- Elisa Zengarini
- Geriatric Medicine and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS INRCA), 60127 Ancona, Italy.
| | - Robertina Giacconi
- Translational Research Center of Nutrition and Ageing, IRCCS INRCA, 60127 Ancona, Italy.
| | | | | | | | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 11330 Stockholm, Sweden.
- Department of Cardiovascular, Metabolic and Aging Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Graziano Onder
- Department of Cardiovascular, Metabolic and Aging Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Stefano Volpato
- Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, 44121 Ferrara, Italy.
| | - Carmelinda Ruggiero
- Section of Gerontology and Geriatrics, Department of Medicine, University of Perugia, 06156 Perugia, Italy.
| | - Paolo Fabbietti
- Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, 60127 Ancona, Italy.
| | - Antonio Cherubini
- Geriatric Medicine and Geriatric Emergency Care, Italian National Research Center on Aging (IRCCS INRCA), 60127 Ancona, Italy.
| | - Francesco Guarasci
- Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, 60127 Ancona, Italy.
| | - Andrea Corsonello
- Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, 60127 Ancona, Italy.
| | - Fabrizia Lattanzio
- Italian National Research Center on Aging, Scientific Direction, IRCCS INRCA, 60127 Ancona, Italy
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15
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Maggio M, Lauretani F. Prevalence, incidence, and clinical impact of cognitive-motoric risk syndrome in Europe, USA, and Japan: facts and numbers update 2019. J Cachexia Sarcopenia Muscle 2019; 10:953-955. [PMID: 31408280 PMCID: PMC6818443 DOI: 10.1002/jcsm.12476] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A new syndrome called the 'motoric-cognitive risk' (MCR) syndrome has recently been proposed in older persons. According to this definition, the parallel impairment in muscle and brain function is more predictive for identifying subjects at risk of dementia than impairment a in single system alone. Epidemiological studies suggest that among older persons, enrolled in worldwide population-based studies, 10% are affected by this syndrome, which confers a higher risk of future disability. In detail, the prevalence of MCR in Europe is around 8.0%, 7.0% in the United States, and 6.3% in Japan. The incidence of the MCR syndrome is estimated to be 65.2 per 1000 person years in adults aged 60 years or older. Many studies reported negative outcomes of the syndrome in older persons, emphasizing its clinical impact. In particular, in almost all longitudinal studies, MCR produces a three-time increased risk of future dementia. In Europe, data from the InCHIANTI study report an increased risk of 2.74 [1.54-4.86], which is 2.49 [1.52-4.10] in the United States and 3.27 [1.55-6.90] in Japan. The studies in different continents are also consistent in showing an increased risk of all-cause mortality, which is 1.50-1.87 in the Europeans and 1.69 [1.08-2.02] for incident disability in Japan. For the identification of the MCR syndrome, different tests and procedures have been proposed, with a final 'core-battery' that includes gait speed, dual-task gait speed, the Montreal Cognitive Assessment and Trail Making Test A and B. The criteria used to select this core-battery were based on the best accuracy for identifying older persons at risk of negative outcomes such as dementia, falls, aging-related disabilities, and sensitivity to interventions. The selection of these tests will allow to start studies aimed to better capture older persons at higher risk of mobility and cognitive disability. By these tests, it will be possible to better evaluate the effect of treatment composing of tailored physical exercise, nutritional suggestions, and medical therapy to overturn negative effect of both cognitive and motoric frailty. This article provides an overview of the current knowledge of the MCR syndrome.
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Affiliation(s)
- Marcello Maggio
- Geriatric Clinic Unit, Medicine and Geriatric-Rehabilitation Department, and Department of Medicine and Surgery, University of Parma, University Hospital of Parma, Parma, Italy.,Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University Hospital of Parma, Parma, Italy
| | - Fulvio Lauretani
- Geriatric Clinic Unit, Medicine and Geriatric-Rehabilitation Department, and Department of Medicine and Surgery, University of Parma, University Hospital of Parma, Parma, Italy.,Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University Hospital of Parma, Parma, Italy
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16
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Kwon I, Kim JS, Shin CH, Park Y, Kim JH. Associations Between Skeletal Muscle Mass, Grip Strength, and Physical and Cognitive Functions in Elderly Women: Effect of Exercise with Resistive Theraband. J Exerc Nutrition Biochem 2019; 23:50-55. [PMID: 31743974 PMCID: PMC6823645 DOI: 10.20463/jenb.2019.0023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 09/28/2019] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The purpose of this study was to identify the relationships between muscle mass, muscle strength, and physical and cognitive functions and to examine the effects of resistive Theraband® exercise on sarcopenia-associated variables in the older population. METHODS A total of 28 elderly women (age: 69.90 ± 0.8 years) participated in this study, 15 of whom underwent elastic band exercise for 1 hour per day, twice per week for 8 weeks. The correlation analysis was conducted to identify the associations between body composition, skeletal muscle mass indices, grip strength, and physical and cognitive functions. All variables were assessed at baseline and post-exercise. RESULTS Skeletal muscle mass was significantly associated with grip strength and physical function. Gait speed was positively correlated with grip strength and physical function, but not with cognitive function. Theraband® exercise significantly improved gait speed and physical function. CONCLUSION The present data suggest that skeletal muscle mass is highly correlated with grip strength and physical function. Eight weeks of resistive Theraband® exercise favorably affects sarcopenia by improving gait speed and mobility of elderly women.
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17
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Szlejf C, Suemoto CK, Lotufo PA, Benseñor IM. Association of Sarcopenia With Performance on Multiple Cognitive Domains: Results From the ELSA-Brasil Study. J Gerontol A Biol Sci Med Sci 2019; 74:1805-1811. [DOI: 10.1093/gerona/glz118] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
Sarcopenia and cognitive impairment share pathophysiological paths and risk factors. Our aim was to investigate the association of sarcopenia and its defining components with cognitive performance in middle-aged and older adults.
Methods
This cross-sectional analysis included 5,038 participants from the ELSA-Brasil Study, aged ≥ 55 years. Muscle mass was evaluated by bioelectrical impedance analysis and muscle strength by handgrip strength. Sarcopenia was defined according to the Foundation for the National Institutes of Health. Cognition was evaluated using delayed word recall test, semantic verbal fluency test, and trail making test version B. Possible confounders included sociodemographic characteristics, lifestyle, and clinical comorbidities.
Results
The frequencies of sarcopenia, low muscle mass, and low muscle strength were 1.8%, 23.3%, and 4.4%, respectively. After adjustment for possible confounders, poorer performance on the verbal fluency test was associated with sarcopenia (β = −0.20, 95% confidence interval [CI] = −0.38; −0.01, p = .03) and low muscle mass (β = −0.08, 95% CI = −0.14; −0.01, p = .02). Low muscle strength was associated with poorer performance in the delayed word recall test (β = −0.14, 95% CI = −0.27; −0.02, p = .02), verbal fluency test (β = −0.14, 95% CI = −0.26; −0.02, p = .03), and trail making test (β = −0.15, 95% CI = −0.27; −0.03, p = .01).
Conclusions
Sarcopenia was associated with poorer performance on the verbal fluency test, and low muscle strength was associated with poorer performance in all cognitive tests in middle-aged and older adults.
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Affiliation(s)
- Claudia Szlejf
- Center for Clinical and Epidemiological Research, Hospital Universitario, University of Sao Paulo, Brazil
- Department of Diagnostic and Ambulatory Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Claudia K Suemoto
- Center for Clinical and Epidemiological Research, Hospital Universitario, University of Sao Paulo, Brazil
- Division of Geriatrics, University of Sao Paulo Medical School, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, University of Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitario, University of Sao Paulo, Brazil
- Department of Internal Medicine, University of Sao Paulo Medical School, Brazil
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Sánchez-Rodríguez D, Marco E, Schott AM, Rolland Y, Blain H, Vázquez-Ibar O, Escalada F, Duran X, Muniesa JM, Annweiler C. Malnutrition according to ESPEN definition predicts long-term mortality in general older population: Findings from the EPIDOS study-Toulouse cohort. Clin Nutr 2018; 38:2652-2658. [PMID: 30551898 DOI: 10.1016/j.clnu.2018.11.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/23/2018] [Accepted: 11/26/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND The European Society of Clinical Nutrition and Metabolism (ESPEN) has developed a consensus definition of malnutrition. This study aimed to determine the prevalence of malnutrition according to the ESPEN definition in otherwise healthy community-dwelling older women and to explore its value for predicting long-term mortality in this population. METHODS This prospective population-based cohort study included 181 women (age ≥75 years) from a subsample of the EPIDémiologie de l'OStéoporose (EPIDOS) study participants from Toulouse. Inclusion criteria were the availability of the data on variables required to apply the ESPEN definition and survival after 7 years of follow-up. Primary outcome was mortality at 12-year follow-up; main covariates were malnutrition assessment according to the ESPEN consensus and its components (unintentional weight loss, BMI, and FFMI). Body composition was assessed by dual-energy X-ray absorptiometry at baseline and at 7-year follow-up. Kaplan-Meier survival curves and adjusted Cox regressions were performed. Analysis was adjusted for age, hypertension, diabetes mellitus, and coronary heart disease as potential confounders. RESULTS Complete data were available for 179 of the 181 women in the EPIDOS-Toulouse cohort (83.1 ± 2.2 years) and 13 (7.3%) fulfilled the ESPEN definition for malnutrition at 7-year follow-up. Malnutrition was associated with increased risk of mortality (adjusted HR = 4.4 [95%CI: 1.7-11.3]). Among the ESPEN components, only BMI was associated with increased mortality (adjusted HR=0.6 [95%CI: 0.4-0.9]). CONCLUSIONS Although malnutrition prevalence according to the ESPEN definition was relatively low (7.3%) in this sample of otherwise healthy community-dwelling older French women, malnutrition was associated with 4.4-fold higher mortality risk at 12-year follow-up.
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Affiliation(s)
- Dolores Sánchez-Rodríguez
- Geriatrics Department, Parc de Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona, Spain; Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Ester Marco
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain
| | - Anne-Marie Schott
- Department IMER, Lyon University Hospital, EA 4129, RECIF, University of Lyon, Inserm, U831, Lyon, France.
| | - Yves Rolland
- Department of Geriatrics, Toulouse University Hospital, Gerontopole of Toulouse, INSERM U1027, University of Toulouse III, Toulouse, France.
| | - Hubert Blain
- Department of Internal Medicine and Geriatrics, Montpellier University Hospital, University of Montpellier 1, Montpellier, France
| | - Olga Vázquez-Ibar
- Geriatrics Department, Parc de Salut Mar (Centre Fòrum - Hospital del Mar), Barcelona, Spain; School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | - Ferran Escalada
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain
| | - Xavier Duran
- Methodology and Biostatistics Support Unit, Institut Hospital del Mar d'Investigacions Mèdiques, (IMIM), Barcelona, Spain
| | - Josep M Muniesa
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Physical Medicine and Rehabilitation Department, Parc Salut Mar (Hospital del Mar - Hospital de l'Esperança), Barcelona, Spain
| | - Cédric Annweiler
- Department of Neurosciences and Aging, Division of Geriatric Medicine, Angers University Hospital, Angers University Memory Clinic, Research Center on Autonomy and Longevity, UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
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19
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Muscle profile and cognition in patients with Alzheimer's disease dementia. Neurol Sci 2018; 39:1861-1866. [PMID: 30084072 DOI: 10.1007/s10072-018-3505-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/17/2018] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Neurodegenerative disease is one of the main contributing factors affecting muscle atrophy. However, this intriguing brain-muscle axis has been explained by the unsubstantial mechanisms. Although there have been several studies that have evaluated the muscle profile and its relation to cognition in patients with dementia, there is still lack of data using standardized methods and only few published studies on Korean populations. The objective of this study is to evaluate the relationship of muscle mass and strength to cognition in patients with Alzheimer's disease dementia (AD). METHODS We recruited 91 patients with probable AD without weakness. We assessed patients' basic demographic characteristics, vascular risk, body mass index, and global cognitive assessment scores. Muscle mass was measured using body dual-energy X-ray absorptiometry. Muscle strength was assessed by isokinetic knee extensor using an isokinetic device at an angular velocity of 60°/s in nm/kg. RESULTS The muscle mass and strength were not related to each other in both male and female groups. Only muscle strength, but not muscle mass, was negatively related to cognition. After adjusting for covariates, the relationship between muscle strength and cognition still remained in the male group, however, was attenuated in the female group. CONCLUSIONS In patients with AD dementia, abundant muscle mass did not mean strong power. The simple lower-extremity muscle strength assessment is more effective in predicting cognition than a muscle mass measure in male patients.
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LEE I, CHO J, HONG H, JIN Y, KIM D, KANG H. Sarcopenia Is Associated with Cognitive Impairment and Depression in Elderly Korean Women. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:327-334. [PMID: 29845019 PMCID: PMC5971168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Sarcopenia has been implicated in the increased risk for cognitive impairment and depression associated with aging. In this cross-sectional study, we investigated the relationship of sarcopenia with cognitive impairment (MCI) and depression in a sample of 201 community-dwelling Korean women (mean age of 74.0±6.8 yr) between 2014 and 2015. METHODS The Korean version of mini-mental state examination and the center for epidemiologic studies depression scale was used to assess cognitive performance and depression, respectively. Grp strength was measured with a dynamometer. Demographics, body composition, education, alcohol consumption, and history of cardiovascular diseases were assessed as covariates. RESULTS Odds ratio (OR) and 95% confidence interval (95% CI) of MCI and depression were calculated according to sarcopenia status. Compared to non-sarcopenic, pre-sarcopenic and sarcopenic women had the ORs of 2.160 (95% CI of 0.840 - 5.554, P=0.030) and of 5.493 (95% CI of 1.854 - 16.270, P=0.002) for MCI. The OR of pre-sarcopenia for MCI remained significant (P=0.030) even after adjustments for age, body mass index (BMI), lean body mass, and education, while the OR of sarcopenia for MCI was no longer significant (P=0.084) when adjusted for the covariates. Compared to non-sarcopenic, pre-sarcopenic and sarcopenic women had the ORs of 3.750 (95% CI of 1.137 - 12.370, P=0.030) and of 4.687 (95% CI of 1.127-19.505, P=0.034) for depression. The ORs of pre-sarcopenia and sarcopenia for depression remained statistically significant (P=0.020 and P=0.042, respectively) even after adjusted for the covariates. CONCLUSION Sarcopenia was significantly associated with MCI and depression in otherwise healthy community dwelling elderly Korean women.
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21
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Kohara K, Okada Y, Ochi M, Ohara M, Nagai T, Tabara Y, Igase M. Muscle mass decline, arterial stiffness, white matter hyperintensity, and cognitive impairment: Japan Shimanami Health Promoting Program study. J Cachexia Sarcopenia Muscle 2017; 8:557-566. [PMID: 28371474 PMCID: PMC5566649 DOI: 10.1002/jcsm.12195] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 12/08/2016] [Accepted: 01/26/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is a close association between frailty and cognitive impairment. However, the underlying contribution of sarcopenia to the development of cognitive impairment is unclear. We investigated the possible association between muscle mass decline and cognitive impairment in a cross-sectional study of 1518 subjects aged 55 years or above. We also evaluated arterial stiffness and white matter hyperintensities (WMHs) as possible underlying mechanisms for this association. METHODS Two sarcopenic indices were measured: thigh muscle cross-sectional area (CSA; calculated by computed tomography) and skeletal muscle mass (bioelectric impedance). Muscle mass decline was defined as either the bottom 10% or 20% of participants for each sex. Cognitive function was assessed using the Touch Panel-type Dementia Assessment Scale, and brachial-ankle pulse wave velocity was measured as an index of arterial stiffness. RESULTS Both sarcopenic indices were modestly but significantly associated with brachial-ankle pulse wave velocity in male and female subjects. The presence of WMHs was significantly associated with low thigh muscle CSA in men and with low skeletal muscle mass in women. The Touch Panel-type Dementia Assessment Scale score was modestly but significantly and positively associated with thigh muscle CSA in men and skeletal muscle mass in women. Muscle mass decline in the bottom 10% of participants on both sarcopenic indices was significantly and independently related to cognitive impairment in women. CONCLUSIONS Lower sarcopenic indices are significantly related to lower cognitive scores. Arterial stiffness and WMHs could account, at least in part, for this association.
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Affiliation(s)
- Katsuhiko Kohara
- Faculty of Collaborative Regional Innovation, Ehime University, 3 Bunkyo-cho, Matsuyama, Ehime, 790-8577, Japan
| | - Yoko Okada
- Department of Geriatric Medicine and Neurology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Masayuki Ochi
- Department of Geriatric Medicine and Neurology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Maya Ohara
- Department of Geriatric Medicine and Neurology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Tokihisa Nagai
- Department of Geriatric Medicine and Neurology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
| | - Yasuharu Tabara
- Department of Medical Genetics, Kyoto University Graduate School of Medicine, 53 Shogoinkawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Michiya Igase
- Department of Geriatric Medicine and Neurology, Ehime University Graduate School of Medicine, Toon City, Ehime, 791-0295, Japan
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Gait characteristics under different walking conditions: Association with the presence of cognitive impairment in community-dwelling older people. PLoS One 2017; 12:e0178566. [PMID: 28570662 PMCID: PMC5453541 DOI: 10.1371/journal.pone.0178566] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 05/15/2017] [Indexed: 01/24/2023] Open
Abstract
Background Gait characteristics measured at usual pace may allow profiling in patients with cognitive problems. The influence of age, gender, leg length, modified speed or dual tasking is unclear. Methods Cross-sectional analysis was performed on a data registry containing demographic, physical and spatial-temporal gait parameters recorded in five walking conditions with a GAITRite® electronic carpet in community-dwelling older persons with memory complaints. Four cognitive stages were studied: cognitively healthy individuals, mild cognitive impaired patients, mild dementia patients and advanced dementia patients. Results The association between spatial-temporal gait characteristics and cognitive stages was the most prominent: in the entire study population using gait speed, steps per meter (translation for mean step length), swing time variability, normalised gait speed (corrected for leg length) and normalised steps per meter at all five walking conditions; in the 50-to-70 years old participants applying step width at fast pace and steps per meter at usual pace; in the 70-to-80 years old persons using gait speed and normalised gait speed at usual pace, fast pace, animal walk and counting walk or steps per meter and normalised steps per meter at all five walking conditions; in over-80 years old participants using gait speed, normalised gait speed, steps per meter and normalised steps per meter at fast pace and animal dual-task walking. Multivariable logistic regression analysis adjusted for gender predicted in two compiled models the presence of dementia or cognitive impairment with acceptable accuracy in persons with memory complaints. Conclusion Gait parameters in multiple walking conditions adjusted for age, gender and leg length showed a significant association with cognitive impairment. This study suggested that multifactorial gait analysis could be more informative than using gait analysis with only one test or one variable. Using this type of gait analysis in clinical practice could facilitate screening for cognitive impairment.
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Bae S, Shimada H, Park H, Lee S, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Suzuki T. Association between body composition parameters and risk of mild cognitive impairment in older Japanese adults. Geriatr Gerontol Int 2017; 17:2053-2059. [PMID: 28485046 DOI: 10.1111/ggi.13018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 12/21/2016] [Accepted: 01/17/2017] [Indexed: 12/25/2022]
Abstract
AIM The aim of the present study was to investigate the association between various body composition parameters and the risk of mild cognitive impairment (MCI) in older Japanese adults, as well as potential sex-related differences in the risk of MCI. METHODS Participants underwent cognitive tests, and were divided into 840 participants with MCI (mean age 71.9 ± 5.5 years) and 1740 without MCI (mean age 71.3 ± 5.2 years). Body composition parameters were measured using a bioelectrical impedance analyzer. Multiple logistic regression analysis was then carried out to examine the associations between body composition parameters and risk of MCI. RESULTS After adjusting for confounding factors, those in the lowest quartile for fat-free mass had a higher risk of MCI than those in the highest quartile (men: odds ratio [OR] 1.96, 95% confidence interval CI 1.24-3.10; women: OR 1.49, 95% CI 1.01-2.19). Loss of muscle mass in the upper (OR 2.17, 95% CI 1.40-3.37) and lower (OR 1.99, 95% CI 1.25-3.15) limbs was associated with a higher MCI risk in men. However, only loss of muscle mass in the lower limbs was associated with a higher MCI risk (OR 1.61, 95% CI 1.06-2.44) in women. No associations were found between obesity measures and MCI. CONCLUSIONS We found that loss of fat-free mass was associated with MCI in older adults, regardless of sex. We also found that appendicular muscle mass was more closely associated with MCI in men than in women. These results suggest that the association between appendicular muscle mass and MCI might have different underlying mechanisms based on sex. Geriatr Gerontol Int 2017; 17: 2053-2059.
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Affiliation(s)
- Seongryu Bae
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hyuntae Park
- Department of Health Care Science College of Health Sciences, Dong-A University, Busan, Korea
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hyuma Makizako
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Daisuke Yoshida
- Department of Physical Therapy, Faculty of Rehabilitation, Kyushu Nutrition Welfare University, Kitakyushu, Fukuoka, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yuya Anan
- Department of Nutritional Health, Faculty of Wellness Studies, Kwassui Women's University, Nagasaki, Japan
| | - Takao Suzuki
- Research Institute of Aging and Development, J.F. Oberlin University, Tokyo, Japan
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Nishiguchi S, Yamada M, Shirooka H, Nozaki Y, Fukutani N, Tashiro Y, Hirata H, Yamaguchi M, Tasaka S, Matsushita T, Matsubara K, Tsuboyama T, Aoyama T. Sarcopenia as a Risk Factor for Cognitive Deterioration in Community-Dwelling Older Adults: A 1-Year Prospective Study. J Am Med Dir Assoc 2016; 17:372.e5-8. [DOI: 10.1016/j.jamda.2015.12.096] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 01/26/2023]
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Papachristou E, Ramsay SE, Lennon LT, Papacosta O, Iliffe S, Whincup PH, Wannamethee SG. The relationships between body composition characteristics and cognitive functioning in a population-based sample of older British men. BMC Geriatr 2015; 15:172. [PMID: 26692280 PMCID: PMC4687114 DOI: 10.1186/s12877-015-0169-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/11/2015] [Indexed: 12/16/2022] Open
Abstract
Background Current research has established obesity as one of the main modifiable risk factors for cognitive impairment. However, evidence on the relationships of total and regional body composition measures as well as sarcopenia with cognitive functioning in the older population remains inconsistent. Methods Data are based on 1,570 participants from the British Regional Heart Study (BRHS), a cohort of older British men from 24 British towns initiated in 1978–80, who were re-examined in 2010–12, aged 71–92 years. Cognitive functioning was assessed with the Test-Your-Memory cognitive screening tool. Body composition characteristics assessed using bioelectrical impedance analysis included total fat mass (FM), central FM, peripheral FM, and visceral fat level. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP) definition of severe sarcopenia and the Foundation for the National Institutes of Health (FNIH) sarcopenia project criteria. Results Among 1,570 men, 636 (41 %) were classified in the mild cognitive impairment (MCI) and 133 (8 %) in the severe cognitive impairment (SCI) groups. Age-adjusted multinomial logistic regressions showed that compared with participants in the normal cognitive ageing group, those with SCI were more likely to have waist circumference >102 cm, BMI >30 kg/m2, to be in the upper quintile of total FM, central FM, peripheral FM and visceral fat level and to be sarcopenic. The relationships remained significant for total FM (RR = 2.16, 95 % CI 1.29–3.63), central FM (RR = 1.85, 95 % CI 1.09–3.14), peripheral FM (RR = 2.67, 95 % CI 1.59–4.48), visceral fat level (RR = 2.28, 95 % CI 1.32–3.94), BMI (RR = 2.25, 95 % CI 1.36–3.72) and waist circumference (RR = 1.63, 95 % CI 1.05–2.55) after adjustments for alcohol, smoking, social class, physical activity and history of cardiovascular diseases or diabetes. After further adjustments for interleukin-6 and insulin resistance, central FM, waist circumference and sarcopenia were no longer significantly associated with SCI. Conclusions Increased levels of peripheral FM, visceral fat level, and BMI are associated with SCI among older people. Distinct pathophysiological mechanisms link regional adipose tissue deposition and cognitive functioning.
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Affiliation(s)
- Efstathios Papachristou
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
| | - Sheena E Ramsay
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Lucy T Lennon
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Olia Papacosta
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Steve Iliffe
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - S Goya Wannamethee
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
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26
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Abstract
BACKGROUND Whether older adults with sarcopenia who underperform controls on tests of physical performance and cognition also have a higher likelihood of combined cognitive-physical impairment is not clear. We assessed the impact of sarcopenia on impairment in both aspects of functionality and the relative contribution of its components, muscle mass and strength. METHODS Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female) were recruited and underwent physical functionality, anthropometry, and cognitive testing. Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2), physical impairment (Mini Physical Performance Test <12), both, or neither by ordinal logistic regression. RESULTS Compared to controls, those with sarcopenia were six times more likely to have combined cognitive impairment/physical impairment with a fully adjusted model showing a three-fold increased odds ratio. The results were consistent across different measures of global cognition (odds ratio =3.46, 95% confidence interval =1.07-11.45 for the Montreal Cognitive Assessment; odds ratio =3.61, 95% confidence interval =1.11-11.72 for Ascertaining Dementia 8). Pre-sarcopenic participants were not different from controls. The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass. CONCLUSION Individuals with sarcopenia are not only more likely to have single but also to have dual impairment in cognitive and physical function. Interventions designed to prevent sarcopenia and improve muscle strength may help reduce the burden of cognitive and physical impairments of functionality in community-dwelling seniors.
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Affiliation(s)
- Magdalena I Tolea
- Alzheimer’s Disease Center, Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - James E Galvin
- Alzheimer’s Disease Center, Department of Neurology, New York University School of Medicine, New York, NY, USA
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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