Liu Xiaolei, Xia Xin, Hu Fengjuan, Hou Lisha, Jia Shuli, Liu Yixin, Deng Linghui, Zhang Yan, Zhao Wanyu, Zhang Gongchang, Yue Jirong, Dong Birong
National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Geriatric Health Care and Medical Research Center, Sichuan University, Chengdu, Sichuan Province, China.
Aging (Albany NY). 2021 Mar 10;13(6):8599-8610. doi: 10.18632/aging.202672.
In this study, we investigated whether nutrition status mediates the relationship between cognitive decline and sarcopenia. Sarcopenia was assessed in 4023 community-dwelling older adults from West China using the AWGS 2014 diagnostic criteria. Cognitive function and nutrition status were assessed using the 10-item Short Portable Mental Status Questionnaire (SPMSQ) and Mini Nutrition Assessment-Short Form (MNA-SF) scale, respectively. Mediation model regression analysis demonstrated that nutrition status was negatively associated with sarcopenia (β = -0.521; 95% CI: -0.583 to -0.459). The indirect effects of cognitive decline on sarcopenia were significant after adjusting for age, sex, and ethnicity (β = 0.015; 95% CI: 0.012 to 0.017), but the direct effects of cognitive decline on sarcopenia were not statistically significant after adding nutrition status as a parameter in the mediation model analysis (β = -0.001; 95% CI: -0.008 to 0.005). Structural equation model (SEM) framework pathway analysis confirmed the association between nutrition status, cognitive decline, and sarcopenia. These findings demonstrate that the negative effects of cognitive decline on sarcopenia were mediated by nutrition status. We therefore postulate that maintaining a good nutrition status delays the negative effects of cognitive decline on sarcopenia in older adults.
在本研究中，我们调查了营养状况是否介导认知功能衰退与肌肉减少症之间的关系。采用2014年亚洲肌少症工作组（AWGS）诊断标准，对来自中国西部的4023名社区居住老年人进行了肌肉减少症评估。分别使用10项简易便携式精神状态问卷（SPMSQ）和微型营养评定简表（MNA-SF）对认知功能和营养状况进行评估。中介模型回归分析表明，营养状况与肌肉减少症呈负相关（β = -0.521；95%置信区间：-0.583至-0.459）。在调整年龄、性别和种族后，认知功能衰退对肌肉减少症的间接效应显著（β = 0.015；95%置信区间：0.012至0.017），但在中介模型分析中加入营养状况作为参数后，认知功能衰退对肌肉减少症的直接效应无统计学意义（β = -0.001；95%置信区间：-0.008至0.005）。结构方程模型（SEM）框架路径分析证实了营养状况、认知功能衰退和肌肉减少症之间的关联。这些发现表明，认知功能衰退对肌肉减少症的负面影响是由营养状况介导的。因此，我们推测，保持良好的营养状况可延缓认知功能衰退对老年人肌肉减少症的负面影响。
