Department of Neuropsychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
Department of Nursing, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan.
Psychogeriatrics. 2020 Nov;20(6):858-864. doi: 10.1111/psyg.12593. Epub 2020 Aug 6.
Few studies have investigated sarcopenia in patients with cognitive impairment. However, identifying the characteristics and factors associated with sarcopenia in these patients may help to decrease the risk of falls, prevent disabilities, and maintain an independent life, all of which can affect the quality of life of both patient and caregiver. Therefore, the aim of this study was to investigate associated factors of sarcopenia in patients with mild to moderate Alzheimer's disease.
This cross-sectional study enrolled 125 outpatients aged 65 to 89 years (mean age 79.5 ± 7.9 years) from January 2018 to December 2018. In addition to demographic characteristics, cognitive status, depressive mood, activities of daily living, body mass index (BMI), handgrip strength, gait speed, muscle mass, and serum levels of 25-hydroxyvitamin D (Vit D), haemoglobin (Hb), albumin and creatinine were assessed. Sarcopenia was defined based on the presence of low muscle mass and either low muscle strength or low physical performance.
Overall, 29.6% of the patients had sarcopenia. The patients with sarcopenia were mostly male, significantly older, and had a lower BMI and lower levels of Vit D. The female patients with sarcopenia were more likely to have lower levels of Hb. Multiple logistic regression showed that sarcopenia was associated with BMI in both genders. The level of Vit D was associated with sarcopenia in the female patients, whereas age was associated with sarcopenia in the male patients.
A low BMI may be a dementia-related risk factor for sarcopenia. The female patients with sarcopenia were more likely to have lower levels of Hb and Vit D. There may be different risk profiles for sarcopenia in men and women with Alzheimer's disease. Further studies are needed to devise different nutritional support for muscle weakness in patients with cognitive decline by gender.
很少有研究调查认知障碍患者的肌肉减少症。然而，确定这些患者中肌肉减少症的特征和相关因素可能有助于降低跌倒风险、预防残疾和维持独立生活，所有这些都可以影响患者和护理人员的生活质量。因此，本研究旨在探讨轻度至中度阿尔茨海默病患者肌肉减少症的相关因素。
本横断面研究纳入了 2018 年 1 月至 12 月期间年龄在 65 至 89 岁（平均年龄 79.5 ± 7.9 岁）的 125 名门诊患者。除了人口统计学特征、认知状态、抑郁情绪、日常生活活动、体重指数（BMI）、手握力、步态速度、肌肉质量和血清 25-羟维生素 D（Vit D）、血红蛋白（Hb）、白蛋白和肌酐水平外，还评估了肌肉减少症。根据肌肉质量低和肌肉力量或身体表现低的情况，定义了肌肉减少症。
总体而言，29.6%的患者患有肌肉减少症。患有肌肉减少症的患者主要为男性，年龄明显较大，BMI 较低，Vit D 水平较低。患有肌肉减少症的女性患者 Hb 水平较低的可能性更大。多变量逻辑回归显示，肌肉减少症与两性的 BMI 相关。Vit D 水平与女性患者的肌肉减少症相关，而年龄与男性患者的肌肉减少症相关。
低 BMI 可能是痴呆相关的肌肉减少症危险因素。患有肌肉减少症的女性患者更有可能 Hb 和 Vit D 水平较低。阿尔茨海默病男性和女性的肌肉减少症可能有不同的风险特征。需要进一步的研究来制定针对认知能力下降的不同性别患者肌肉无力的不同营养支持。
