Someya Yuki, Tamura Yoshifumi, Kaga Hideyoshi, Sugimoto Daisuke, Kadowaki Satoshi, Suzuki Ruriko, Aoki Shigeki, Hattori Nobutaka, Motoi Yumiko, Shimada Kazunori, Daida Hiroyuki, Ishijima Muneaki, Kaneko Kazuo, Nojiri Shuko, Kawamori Ryuzo, Watada Hirotaka
Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Clin Nutr. 2022 May;41(5):1046-1051. doi: 10.1016/j.clnu.2022.03.017. Epub 2022 Mar 16.
BACKGROUND & AIMS: Coexistence of obesity and decreased muscle strength, defined as sarcopenic obesity, is often observed in the older adults. The present study investigated whether sarcopenic obesity, defined as reduced handgrip strength and increased body mass index (BMI), is associated with cognitive impairment.
Study participants include 1615 older adults aged 65-84 years who lived in an urban area of Tokyo, Japan and participated in the Bunkyo Health Study. Mild cognitive impairment (MCI) and dementia were defined based on ≤22 points of Montreal Cognitive Assessment and ≤23 points of the Mine-Mental State Examination, respectively. Handgrip strength was measured using a dynamometer in a standing position. We divided participants into four groups according to their sarcopenia (probable) (handgrip strength <28 kg in men and <18 kg in women) and obesity status (BMI ≥25 kg/m) as control, obesity, sarcopenia and sarcopenic obesity, and investigated the association between cognitive function, sarcopenia, and obesity status.
Mean age was 73.1 ± 5.4 years, and 57.6% of study participants were female. The prevalence of control, obesity, sarcopenia, and sarcopenic obesity was 59.4%, 21.2%, 14.6%, and 4.7%, respectively. The prevalence of MCI and dementia, respectively, was highest in participants with sarcopenic obesity, followed by those with sarcopenia, obesity, and control. After multivariate adjustment, sarcopenic obesity was independently associated with increased odds of MCI and dementia compared with the control (MCI: 2.11 [95% confidence interval, 1.12-3.62]; dementia: 6.17 [2.50-15.27]).
Sarcopenic obesity was independently associated with MCI and dementia among Japanese older adults. Future studies are necessary to clarify the causal relationship.
肥胖与肌肉力量下降同时存在，即肌肉减少性肥胖，在老年人中较为常见。本研究调查了以握力降低和体重指数（BMI）升高定义的肌肉减少性肥胖是否与认知障碍有关。
研究参与者包括1615名年龄在65 - 84岁之间、居住在日本东京市区且参加了文京区健康研究的老年人。轻度认知障碍（MCI）和痴呆分别根据蒙特利尔认知评估得分≤22分和简易精神状态检查表得分≤23分来定义。使用测力计在站立位测量握力。我们根据参与者的肌肉减少症（可能）（男性握力<28 kg，女性握力<18 kg）和肥胖状况（BMI≥25 kg/m²）将其分为四组，即对照组、肥胖组、肌肉减少症组和肌肉减少性肥胖组，并研究认知功能、肌肉减少症和肥胖状况之间的关联。
平均年龄为73.1±5.4岁，57.6%的研究参与者为女性。对照组、肥胖组、肌肉减少症组和肌肉减少性肥胖组的患病率分别为59.4%、21.2%、14.6%和4.7%。肌肉减少性肥胖参与者中MCI和痴呆的患病率分别最高，其次是肌肉减少症参与者、肥胖参与者和对照组。多变量调整后，与对照组相比，肌肉减少性肥胖与MCI和痴呆的患病几率增加独立相关（MCI：2.11[95%置信区间，1.12 - 3.62]；痴呆：6.17[2.50 - 15.27]）。
在日本老年人中，肌肉减少性肥胖与MCI和痴呆独立相关。未来有必要进行研究以阐明因果关系。
