O'Donovan Gary, Sarmiento Olga L, Hessel Philipp, Muniz-Terrera Graciela, Duran-Aniotz Claudia, Ibáñez Agustín
Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia.
Front Nutr. 2022 Oct 18;9:1011967. doi: 10.3389/fnut.2022.1011967. eCollection 2022.
More research is required to understand associations of body mass index (BMI) and sarcopenia with cognition, especially in Latin America. The objective of this study was to investigate associations of BMI and sarcopenia with mild cognitive impairment in Colombia.
Data were from the National Survey of Health, Wellbeing and Aging in Colombia (SABE Colombia, in Spanish). Community-dwelling adults aged 60 years or older were invited to participate.
Trained interviewers administered a shorter version of the mini-mental state examination and mild cognitive impairment was defined as a score of 12 or less out of 19. Body mass index was defined using standard cut-offs. Sarcopenia was defined as low grip strength or slow chair stands. Logistic regression models were adjusted for age, sex, height, education, income, civil status, smoking, and alcohol drinking.
The prevalence of mild cognitive impairment was 20% in 23,694 participants in SABE Colombia and 17% in 5,760 participants in the sub-sample in which sarcopenia was assessed. Overweight and obesity were associated with decreased risk of mild cognitive impairment and sarcopenia was associated with increased risk. Sarcopenia was a risk factor for mild cognitive impairment in those with normal BMI (adjusted model included 4,911 men and women). Compared with those with normal BMI and without sarcopenia, the odds ratio for mild cognitive impairment was 1.84 in those with normal BMI and sarcopenia (95% confidence interval: 1.25, 2.71). Sarcopenia was also a risk factor in those with obesity but did not present a greater risk than sarcopenia alone. Compared with those with normal BMI and without sarcopenia, the odds ratio was 1.62 in those with obesity and sarcopenia (95% confidence interval: 1.07, 2.48). Sarcopenia was not a risk factor for mild cognitive impairment in those with overweight. Similar results were observed when reference values from Colombia were used to set cut-offs for grip strength. Similar results were also observed in cross-validation models, which suggests the results are robust.
This is the first study of the combined associations of sarcopenia and obesity with cognition in Colombia. The results suggest that sarcopenia is the major predictor of screen-detected mild cognitive impairment in older adults, not overweight or obesity.
需要开展更多研究以了解体重指数（BMI）和肌肉减少症与认知功能之间的关联，尤其是在拉丁美洲。本研究的目的是调查哥伦比亚BMI和肌肉减少症与轻度认知功能障碍之间的关联。
设计、地点与参与者：数据来自哥伦比亚全国健康、幸福与老龄化调查（西班牙语为SABE Colombia）。邀请了60岁及以上的社区居住成年人参与。
经过培训的访员进行简易精神状态检查表的简短版本测试，轻度认知功能障碍定义为19分中得分为12分及以下。BMI采用标准临界值进行定义。肌肉减少症定义为握力低或从椅子上起身缓慢。逻辑回归模型对年龄、性别、身高、教育程度、收入、婚姻状况、吸烟和饮酒情况进行了校正。
在哥伦比亚全国健康、幸福与老龄化调查的23,694名参与者中，轻度认知功能障碍的患病率为20%；在评估了肌肉减少症的子样本的5,760名参与者中，患病率为17%。超重和肥胖与轻度认知功能障碍风险降低相关，而肌肉减少症与风险增加相关。在BMI正常的人群中，肌肉减少症是轻度认知功能障碍的一个风险因素（校正模型纳入了4,911名男性和女性）。与BMI正常且无肌肉减少症的人群相比，BMI正常但有肌肉减少症的人群发生轻度认知功能障碍的比值比为1.84（95%置信区间：1.25, 2.71）。在肥胖人群中，肌肉减少症也是一个风险因素，但并未显示出比单纯肌肉减少症更大的风险。与BMI正常且无肌肉减少症的人群相比，肥胖且有肌肉减少症的人群比值比为1.62（95%置信区间：1.07, 2.48）。在超重人群中，肌肉减少症不是轻度认知功能障碍的风险因素。当使用哥伦比亚的参考值来设定握力临界值时，观察到了类似结果。在交叉验证模型中也观察到了类似结果，这表明结果具有稳健性。
这是哥伦比亚首项关于肌肉减少症和肥胖与认知功能联合关联的研究。结果表明，肌肉减少症是老年人筛查出的轻度认知功能障碍的主要预测因素，而非超重或肥胖。
