Moon J H, Moon J H, Kim K M, Choi S H, Lim S, Park K S, Kim K W, Jang H C
Hak Chul Jang, MD, PhD, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea, Tel: +82-31-787-7005, Fax: +82-31-787-4051, E-mail:
J Nutr Health Aging. 2016;20(5):496-502. doi: 10.1007/s12603-015-0613-x.
We investigated the association between the indices of sarcopenia and future risk of cognitive impairment in older adults.
Community-based prospective cohort study.
Community.
A total of 297 participants aged ≥65 years without cognitive impairment at baseline (mean age, 71.9 ± 6.6 years; men:women, 158:139) and who underwent cognitive evaluation at the 5-year follow-up.
Sarcopenia parameters including appendicular lean mass (ALM), handgrip strength, and the Short Physical Performance Battery (SPPB) score at baseline were compared according to the later progression of mild cognitive impairment (MCI) and/or dementia. The operational criteria suggested by the Foundation for the National Institutes of Health Sarcopenia Project were used. We performed multivariate logistic regression analysis to identify the independent indicators of the progression of cognitive impairment.
Among the 297 participants, 242 (81.5%) remained cognitively normal (nonprogression group), whereas 55 (18.5%) showed progression of cognitive impairment (50 subjects (16.8%) to MCI and 5 subjects (1.7%) to dementia) (progression group). Compared with the nonprogression group, subjects in the progression group were older, had a lower educational level, and had lower physical function as assessed by the SPPB; a higher percentage were depressed. Other baseline markers of sarcopenia, including the ALM-to-body mass index ratio and handgrip strength did not differ significantly between the groups. The association between a low SPPB score (<9) and progression of cognitive impairment was maintained after adjustment for conventional risk factors for cognitive impairment (hazard ratio 2.222, 95% confidence interval 1.047-4.716, P = 0.038).
Decreased physical performance, as assessed by the SPPB, but not other markers of sarcopenia, was independently associated with the risk of later cognitive impairment in older adults.
我们研究了老年人肌肉减少症指标与未来认知障碍风险之间的关联。
基于社区的前瞻性队列研究。
社区。
共有297名年龄≥65岁的参与者，他们在基线时无认知障碍（平均年龄71.9±6.6岁；男性:女性为158:139），并在5年随访时接受了认知评估。
根据轻度认知障碍（MCI）和/或痴呆症的后期进展情况，比较基线时的肌肉减少症参数，包括四肢瘦体重（ALM）、握力和简短体能测试电池（SPPB）评分。采用美国国立卫生研究院肌肉减少症项目基金会建议的操作标准。我们进行了多因素逻辑回归分析，以确定认知障碍进展的独立指标。
在297名参与者中，242名（81.5%）认知功能仍正常（非进展组），而55名（18.5%）出现了认知障碍进展（50名受试者（16.8%）进展为MCI，5名受试者（1.7%）进展为痴呆症）（进展组）。与非进展组相比，进展组的受试者年龄更大，教育水平更低，通过SPPB评估的身体功能更低；抑郁的比例更高。两组之间，其他肌肉减少症的基线指标，包括ALM与体重指数之比和握力，没有显著差异。在对认知障碍的传统危险因素进行调整后，低SPPB评分（<9）与认知障碍进展之间的关联仍然存在（风险比2.222，95%置信区间1.047 - 4.716，P = 0.038）。
通过SPPB评估的身体功能下降，但不是其他肌肉减少症指标，与老年人后期认知障碍风险独立相关。
