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老年人肌少症与轻度认知障碍:来自 CHARLS 的首个纵向证据。

Sarcopenia and mild cognitive impairment among elderly adults: The first longitudinal evidence from CHARLS.

机构信息

National Survey Research Center, Renmin University of China, Beijing, China.

School of Public Health, Fudan University, Shanghai, China.

出版信息

J Cachexia Sarcopenia Muscle. 2022 Dec;13(6):2944-2952. doi: 10.1002/jcsm.13081. Epub 2022 Sep 4.

Abstract

BACKGROUND

The association between sarcopenia and mild cognitive impairment (MCI) among elderly adults in China remains unclear. The present study aimed to examine the association based on a nationally representative large-scale survey.

METHODS

The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018. All subjects met the inclusion criteria were classified based on Asia Working Group for Sarcopenia 2019 criteria. Aging-associated cognitive decline is used to define MCI, and cognitive function is measured based on four dimensions: orientation, computation, memory, and drawing. OLS and logistic regression model were conducted to analyse the cross-sectional association between sarcopenia and different cognitive functions. Logistic regression model was conducted to analyse the longitudinal association between sarcopenia and MCI.

RESULTS

Totally, 5715 participants aged over 60 years (43.8% women; mean age 67.3 ± 6.0 years) were enrolled in a cross-sectional association study in 2015, and further 2982 elderly adults were followed up in 2018. During the period, sarcopenia and possible sarcopenia increased from 8.5% to 29.6%. Scores of cognitive and four dimensions (orientation, computation, memory, and drawing) exhibited a decreasing trend from non-sarcopenia to sarcopenia (P < 0.001). In the fully adjusted OLS regression model, scores of four dimensions were lower in possible sarcopenia and sarcopenia groups when compared with the non-sarcopenia group (P < 0.05) respectively. The incidence of MCI was 10.1%, 16.5%, and 24.2% for non-sarcopenia, possible sarcopenia, and sarcopenia groups from 2015 to 2018, with a significantly statistical difference (P < 0.001). Logistic regression model revealed an odds ratio of 1.43 [95% confidence interval (CI): 1.06-1.91, P = 0.017] for the possible sarcopenia group and 1.72 (95% CI: 1.04-2.85, P = 0.035) for sarcopenia group when compared with the non-sarcopenia group.

CONCLUSIONS

Sarcopenia is associated with worse cognitive impairment, which provided new evidence for a strong association that warrants further research into mechanistic insights.

摘要

背景

中国老年人肌少症与轻度认知障碍(MCI)之间的关联尚不清楚。本研究旨在基于一项具有全国代表性的大规模调查来检验这种关联。

方法

本研究使用了中国健康与退休纵向研究(CHARLS)2015 年和 2018 年的两波数据。所有符合纳入标准的受试者均根据亚洲肌少症工作组 2019 年标准进行分类。与衰老相关的认知衰退用于定义 MCI,认知功能通过四个维度进行测量:定向、计算、记忆和绘画。采用 OLS 和 logistic 回归模型分析肌少症与不同认知功能的横断面关联。采用 logistic 回归模型分析肌少症与 MCI 的纵向关联。

结果

共有 5715 名年龄在 60 岁以上(女性占 43.8%;平均年龄 67.3±6.0 岁)的老年人参加了 2015 年的横断面关联研究,并在 2018 年进一步对 2982 名老年人进行了随访。在此期间,肌少症和可能的肌少症从 8.5%增加到 29.6%。认知和四个维度(定向、计算、记忆和绘画)的评分从非肌少症到肌少症呈下降趋势(P<0.001)。在完全调整的 OLS 回归模型中,与非肌少症组相比,可能的肌少症组和肌少症组的四个维度评分分别较低(P<0.05)。非肌少症、可能的肌少症和肌少症组在 2015 年至 2018 年期间的 MCI 发病率分别为 10.1%、16.5%和 24.2%,差异具有统计学意义(P<0.001)。logistic 回归模型显示,与非肌少症组相比,可能的肌少症组的优势比为 1.43(95%置信区间[CI]:1.06-1.91,P=0.017),肌少症组为 1.72(95%CI:1.04-2.85,P=0.035)。

结论

肌少症与认知障碍程度加重有关,这为两者之间存在密切关联提供了新的证据,需要进一步研究以深入了解其机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cef6/9745544/d33c3f0884c9/JCSM-13-2944-g001.jpg

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