Sarcopenia and cognitive impairment: A systematic review and meta-analysis

Peng, Tao‐Chun; Chen, Wei‐Liang; Wu, Liwei; Chang, Yi‐Wen; Kao, Tung‐Wei

doi:10.1016/j.clnu.2019.12.014

Cited by 194 publications

(206 citation statements)

References 41 publications

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“…Although no studies have examined nutrition as a mediator between sarcopenia and cognitive impairment, studies have highlighted the relationships between sarcopenia and cognitive impairment, sarcopenia and nutrition, and nutrition and cognitive impairment. A recent systematic review of 15 studies ( n = 10,410) found that sarcopenia in older adults increases the risk of cognitive impairment independent of participant characteristics or sarcopenia/cognitive impairment diagnostic criteria [ 11 ]. This meta-analysis indicated that sarcopenia was associated with an approximately twofold increased risk of MCI and dementia [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent systematic review of 15 studies ( n = 10,410) found that sarcopenia in older adults increases the risk of cognitive impairment independent of participant characteristics or sarcopenia/cognitive impairment diagnostic criteria [ 11 ]. This meta-analysis indicated that sarcopenia was associated with an approximately twofold increased risk of MCI and dementia [ 11 ]. Similarly, sarcopenia is common among dementia patients [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Due to the increasing burden associated with dementia and the lack of effective treatments for cognitive impairment, identifying the most vulnerable populations and developing interventions are urgent. Studies have indicated that sarcopenic patients are vulnerable to developing cognitive impairment, and sarcopenia is common among individuals with dementia [ 11 , 12 ]. Likewise, malnutrition is a risk factor for cognitive impairment, common among patients with dementia, and associated with sarcopenia [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Nutritional status mediates the relationship between sarcopenia and cognitive impairment: findings from the WCHAT study

Jia

et al. 2021

Aging Clin Exp Res

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Background Sarcopenia is associated with cognitive impairment in older adults. However, the underlying mechanisms are not fully understood. Aim To explore the mediating role of nutritional status in the relationship between sarcopenia and cognitive impairment. Methods Three thousand eight hundred and ten participants (mean age 61.94 ± 8.01 years) from the West China Health and Aging Trend (WCHAT) study were included. We defined sarcopenia using the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Cognitive status and nutritional status were measured using the Short Portable Mental Status Questionnaire (SPMSQ) and the Mini Nutritional Assessment Short Form (MNA-SF). Relationships between sarcopenia, nutritional status, and cognitive function were explored using multiple linear regression. Two mediation models were generated to examine whether nutritional status mediates the association between sarcopenia and cognitive function using PROCESS macro version 3.5. ResultsThe study involved 3147 (82.6%) non-sarcopenic, 387 (10.2%) sarcopenic, and 276 (7.2%) severely sarcopenic individuals. In mediation model 1, sarcopenia (β = 0.208, 95% CI 0.072 to 0.344, P = 0.0028) was significantly associated with cognitive impairment, and nutritional status mediated this association (indirect effect = 0.162, bootstrap 95% CI 0.116 to 0.212). Mediation model 2 indicated that nutritional status exhibited a full mediating effect regarding the association between sarcopenia and cognitive impairment (indirect effect = 0.131, bootstrap 95% CI: 0.08 to 0.188; direct effect = 0.046, bootstrap 95% CI − 0.115 to 0.21) and a partial mediating effect regarding the association between severe sarcopenia and cognitive impairment (indirect effect = 0.21, bootstrap 95% CI: 0.143 to 0.283; direct effect = 0.476, bootstrap 95% CI: 0.234-0.724). Conclusions The relationship between sarcopenia and cognitive impairment was significantly mediated by nutritional status. Early nutritional interventions may prevent cognitive decline in sarcopenic older adults.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nutritional status mediates the relationship between sarcopenia and cognitive impairment: findings from the WCHAT study

Jia

et al. 2021

Aging Clin Exp Res

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“…Many researchers have tried to explore the connection between sarcopenia and cognitive performance, but there is still no de nite conclusion. Some researches proposed that sarcopenia was associated with an increased risk of cognitive impairment [8,11,12], while the results of some studies indicated that there was no signi cant association between them [13,14]. Our ndings provided strong evidence for the effect of sarcopenia on cognitive performance, which might help to further explore the association between sarcopenia and cognitive performance.…”

Section: Discussionmentioning

confidence: 52%

“…Current evidence indicated that physical activity could improve the symptoms of MCI patients [9], which might suggest that there might be a link between sarcopenia and cognitive impairment. In terms of research results, some researches showed that sarcopenia was signi cantly associated with cognitive impairment [8,11,12], while some studies showed completely opposite results [13,14]. Therefore, in the present paper, we aimed to explore the association between sarcopenia and cognitive performance using data that could represent the U.S. population.…”

Section: Introductionmentioning

confidence: 98%

The Association Between Sarcopenia and Cognitive Performance : Data from the National Health and Nutrition Examination Surveys 1999 to 2002

Geng

Deng

Qiu

et al. 2020

Preprint

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Background: Sarcopenia and cognitive impairment are both age-related diseases. And they have many risk factors in common. However, the association between them has been controversial in recent years.Objective: To investigate the association between sarcopenia and cognitive performance in the U.S. adults through the use of the NHANES data from 1999 to 2002.Methods: A total of 2550 participants were identified in the National Health and Nutrition Examination Surveys Data Base (1999–2002). The independent variable was sarcopenia and the dependent variables was cognitive performance. Men were classified as sarcopenia if appendicular lean mass (ALM) adjusted for BMI (ALMBMI) <0.789, and women<0.512. The cognitive performance was assessed by Digit Symbol Substitution Test (DSST). Higher scores on the DSST indicated better cognitive performance. The covariates included gender, age, race, poverty income ratio, comorbidity index, educational level, physical activity and smoking status.Results: For the primary outcome, our multivariate linear regression analysis indicated that sarcopenia negatively correlated with cognitive performance in the model I (crude OR = 5.18; 95% CI: [3.49–6.87]). The negative association remained significant in the adjusted model II and model III (OR=3.40; 95% CI: [1.91–4.90]; OR=1.50; 95% CI: [0.12–2.89]). The subgroup analysis results indicated that participants without sarcopenia were associated with better cognitive performance was similar in different gender, age, race, poverty income ratio, comorbidity index, educational level, physical activity and smoking status.Conclusions: Participants without sarcopenia were associated with better cognitive performance in a representative sample of older adults in the U.S. We might be able to try to improve cognitive performance by dealing with sarcopenia and provide opportunity for intervention at a younger age and better physical performance.

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Association of Low Muscle Mass With Cognitive Function During a 3-Year Follow-up Among Adults Aged 65 to 86 Years in the Canadian Longitudinal Study on Aging

et al. 2022

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IMPORTANCE Cross-sectional studies have shown that combined low muscle mass and strength are associated with cognitive impairment. Whether low muscle mass, reflective of physiologic reserve, is independently associated with faster cognitive decline remains unknown. OBJECTIVE To investigate the associations between low muscle mass and cognitive decline in 3 distinct domains among adults aged at least 65 years. DESIGN, SETTING, AND PARTICIPANTS The Canadian Longitudinal Study on Aging is a prospective population-based cohort study of community-dwelling adults. Enrollment occurred from 2011 to 2015 with a 3-year follow-up. Analyses for this study were conducted on those aged at least 65 years from April 24 to August 12, 2020. EXPOSURE Appendicular lean soft tissue mass (ALM) was assessed by dual energy x-ray absorptiometry. Low ALM was identified using the sex-specific Canadian cut points. MAIN OUTCOMES AND MEASURES Memory was assessed using the Rey auditory verbal learning test. Executive function was assessed using the mental alternation test, Stroop high interference (words/dot) test, the animal fluency test, and the controlled oral word association test. Psychomotor speed was assessed using computer-administered choice reaction time. Composite scores by domain were created. RESULTSOf 8279 participants, 4003 (48%) were female, 8005 (97%) were White, and the mean (SD) age was 72.9 (5.6) years. A total of 1605 participants (19.4%) had low ALM at baseline.Participants with low ALM were older, had lower body mass index and physical activity level. The presence of low ALM at baseline was associated with faster 3-year cognitive decline in executive functions and psychomotor speed from multiple linear regressions. After adjusting for covariates including age, level of education, percentage body fat, and handgrip strength, low ALM remained independently associated with executive function decline (standardized β: −0.032; P = .03) only.Low ALM was not associated with memory. CONCLUSIONS AND RELEVANCE This cohort study found longitudinal associations between lowALM and cognition in aging. Identification of older adults with low muscle mass, a targetable modifiable factor, may help estimate those at risk for accelerated executive function decline. Further longer-term investigation of associations is warranted.

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Sarcopenia and cognitive impairment: A systematic review and meta-analysis

Cited by 194 publications

References 41 publications

Nutritional status mediates the relationship between sarcopenia and cognitive impairment: findings from the WCHAT study

Nutritional status mediates the relationship between sarcopenia and cognitive impairment: findings from the WCHAT study

The Association Between Sarcopenia and Cognitive Performance : Data from the National Health and Nutrition Examination Surveys 1999 to 2002

Association of Low Muscle Mass With Cognitive Function During a 3-Year Follow-up Among Adults Aged 65 to 86 Years in the Canadian Longitudinal Study on Aging

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