Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221002, Jiangsu, China.
Medical Technology School, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
BMC Geriatr. 2022 Feb 19;22(1):141. doi: 10.1186/s12877-022-02802-4.
Sarcopenia has been identified as a risk factor for cognitive impairment, and motoric cognitive risk syndrome (MCR) is a recently defined pre-dementia syndrome. It is not known whether they are related. We aimed to investigate the association and potential pathways between sarcopenia and MCR in the community elderly by establishing a moderated mediation model.
846 community residents aged ≥ 60 years were recruited from May 2021 to September 2021 and had a comprehensive geriatric evaluation. The diagnosis of sarcopenia followed the criteria issued by the Asian Working Group for Sarcopenia in 2019. MCR was defined as subjective cognitive decline and slow gait. Apathy symptoms and physical activity were assessed by the Apathy Evaluation Scale (AES) and the International Physical Activity Questionnaire (IPAQ). Logistic regression and moderated mediation analyses were conducted to explore the association between the four.
60 (7.1%) had MCR among 846 participants. After full adjustment, sarcopenia (odds ratio [OR] = 3.81, 95% confidence interval [CI] = 1.69-8.60, P = 0.001), AES score (OR = 1.09, 95% CI = 1.04-1.14, P < 0.001), and IPAQ level (OR = 0.43, 95% CI = 0.28-0.66, P < 0.001) were associated with MCR. Apathy partially mediated the relationship between sarcopenia and MCR. Physical activity played a moderation role in the indirect pathway of the mediation model. The increase in physical activity can alleviate the indirect effect of sarcopenia on MCR.
We established a moderated mediation model to uncover the underlying association mechanism of sarcopenia and MCR preliminarily. These findings suggest that attention should be paid to the management of apathy and physical activity in the context of sarcopenia to prevent early dementia actively. Further validation is needed in future longitudinal studies.
肌少症已被确定为认知障碍的一个危险因素，运动认知风险综合征（MCR）是最近定义的一种痴呆前综合征。目前尚不清楚两者之间是否存在关联。我们旨在通过建立调节中介模型来研究社区老年人中肌少症与 MCR 之间的关联和潜在途径。
2021 年 5 月至 2021 年 9 月，共招募了 846 名年龄≥60 岁的社区居民进行全面老年评估。肌少症的诊断遵循 2019 年亚洲肌少症工作组发布的标准。MCR 定义为主观认知下降和步态缓慢。采用淡漠评估量表（AES）和国际体力活动问卷（IPAQ）评估淡漠症状和身体活动。采用 logistic 回归和调节中介分析探讨这四者之间的关系。
846 名参与者中，有 60 人（7.1%）患有 MCR。经过全调整后，肌少症（比值比 [OR] = 3.81，95%置信区间 [CI] = 1.69-8.60，P = 0.001）、AES 评分（OR = 1.09，95% CI = 1.04-1.14，P < 0.001）和 IPAQ 水平（OR = 0.43，95% CI = 0.28-0.66，P < 0.001）与 MCR 相关。淡漠部分介导了肌少症与 MCR 之间的关系。身体活动在中介模型的间接途径中起调节作用。身体活动的增加可以减轻肌少症对 MCR 的间接影响。
我们建立了一个调节中介模型，初步揭示了肌少症和 MCR 之间的潜在关联机制。这些发现表明，在肌少症的背景下，应注意管理淡漠和身体活动，积极预防早期痴呆。未来的纵向研究需要进一步验证。
