Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
Faculty of Public Health, Universitas Airlangga, Surabaya City 60115, Indonesia.
Int J Environ Res Public Health. 2022 Apr 14;19(8):4723. doi: 10.3390/ijerph19084723.
Sarcopenia is a condition that is highly prevalent among older adults. This condition is linked to numerous adverse health outcomes, including cognitive impairment that impairs healthy ageing. While sarcopenia and cognitive impairment may share a common pathway, limited longitudinal studies exist to show the relationship between these two conditions. Therefore, this study aimed to examine the longitudinal association between sarcopenia and cognitive impairment. This is a cohort study among older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia. There were 2404 respondents at the baseline and 1946 respondents at one-year follow-up. Cognitive impairment was determined using Mini-mental State Examination scores. Sarcopenia was identified using the Asian Working Group for Sarcopenia 2019 criteria, gait speed was measured using a 4-meter gait test, handgrip strength was assessed using Jamar handheld dynamometer, and appendicular skeletal muscle mass was measured using bioelectrical impedance analysis. Generalized estimating equation (GEE) was used to determine the longitudinal association between sarcopenia and cognitive impairment, presented as relative risk (RR) and its 95% confidence interval. The prevalence of sarcopenia was 5.0% (95% CI 4.00-5.90), and severe sarcopenia was 3.60% (95% CI 2.84-4.31). Upon adjusting for covariates, older adults with sarcopenia have an 80 per cent increased risk of cognitive impairment compared to those without (RR 1.80; 95% CI 1.18-2.75). Similarly, severe sarcopenia was found to significantly increase the risk of cognitive impairment by 101 per cent in the adjusted model (RR 2.01; 95% CI 1.24-3.27). Our study showed that sarcopenia, severe sarcopenia, low physical activity, depressive symptoms, hearing impairment and chronic pain were associated with a higher risk of cognitive impairment among community-dwelling older adults. Therefore, early intervention to prevent sarcopenia, depressive symptoms, hearing impairment, chronic pain, and higher physical activity among older adults is recommended.
肌少症是老年人中普遍存在的一种病症。这种病症与许多不良健康结果有关，包括认知障碍，从而影响健康老龄化。虽然肌少症和认知障碍可能有共同的发病途径，但目前仅有有限的纵向研究表明这两种情况之间的关系。因此，本研究旨在探讨肌少症和认知障碍之间的纵向关联。这是一项在马来西亚森美兰州瓜拉庇拉地区居住的老年人中进行的队列研究。基线时有 2404 名受访者，一年随访时有 1946 名受访者。认知障碍通过简易精神状态检查评分来确定。肌少症通过亚洲肌少症工作组 2019 标准来识别，步态速度通过 4 米步态测试来测量，手握力通过 Jamar 手持测力计来评估，四肢骨骼肌质量通过生物电阻抗分析来测量。使用广义估计方程（GEE）来确定肌少症和认知障碍之间的纵向关联，结果表示为相对风险（RR）及其 95%置信区间。肌少症的患病率为 5.0%（95%CI 4.00-5.90），严重肌少症的患病率为 3.60%（95%CI 2.84-4.31）。在调整了混杂因素后，与无肌少症的老年人相比，有肌少症的老年人发生认知障碍的风险增加了 80%（RR 1.80；95%CI 1.18-2.75）。同样，在调整后的模型中，严重肌少症使认知障碍的风险显著增加了 101%（RR 2.01；95%CI 1.24-3.27）。我们的研究表明，肌少症、严重肌少症、低身体活动量、抑郁症状、听力障碍和慢性疼痛与社区居住的老年人认知障碍的风险增加有关。因此，建议对老年人进行早期干预，以预防肌少症、抑郁症状、听力障碍、慢性疼痛和提高身体活动量。
