Department of Internal Medicine, Division of Geriatrics, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey.
Department of Internal Medicine, Division of Geriatrics, Gülhane Faculty of Medicine, Ankara Oncology Education and Research Hospital, University of Health Sciences, Ankara, Turkey.
Turk J Med Sci. 2022 Dec;52(6):1926-1932. doi: 10.55730/1300-0144.5540. Epub 2022 Dec 21.
Sarcopenia and dementia are growing concerns among older adults that muscle and brain atrophy may cooccur. We aimed to compare the age-related loss of muscle mass by using ultrasound (US), and skeletal muscle mass index (SMI) by bioelectrical impedance analysis in older adults with and without dementia.
A total of 221 older adults aged ≥65 years were included in the study. The diagnosis of sarcopenia was established if low muscle mass according to either SMI or sonographic gastrocnemius (GC) muscle thickness was combined with low grip strength. The diagnosis of dementia was based on the National Institute of Aging and Alzheimer's Association criteria and the major neurocognitive disorder definition in the Diagnostic and Statistical Manual of Mental Disorders-V. Muscle strength was measured by hand dynamometer and physical performance was assessed by 4-meter usual gait speed.
There were similar/moderate correlation coefficients between GC muscle thickness and SMI with functional parameters (all p < 0.01). Forty-six patients (20.8%) had dementia, and 21 (45.7%) of them had sarcopenia diagnosed by GC thickness (p < 0.001). Age was older but weight, body mass index, and all sarcopenia-related parameters were lower in dementia patients (all p < 0.01). When clinical variables were taken into binary logistic regression analyses, age [OR = 1.095 (95% CI: 1.028-1.167)], weight [OR = 0.918 (95% CI: 0.887-0.950)], and presence of dementia [OR = 5.109 (95% CI: 2.002-13.033)] were independently associated with sarcopenia diagnosed with GC muscle thickness (all p < 0.05).
This study showed that sarcopenia is highly prevalent in older adults with dementia (45.7%) than without dementia (11.4%). Amongst different factors, increased age, having low body weight, and the presence of dementia independently increased the risk of sarcopenia diagnosed by GC muscle thickness (but not diagnosed by SMI) in older adults. Thus, we can evaluate easily and successfully the loss of (regional) muscle mass in dementia patients by using US in outpatient clinics.
肌肉减少症和痴呆症是老年人越来越关注的问题，因为肌肉和大脑可能会同时萎缩。我们旨在比较患有和不患有痴呆症的老年人通过超声（US）测量的肌肉质量与生物电阻抗分析测量的骨骼肌质量指数（SMI）的年龄相关性损失。
本研究共纳入 221 名年龄≥65 岁的老年人。如果根据 SMI 或超声测定的腓肠肌（GC）肌肉厚度低，同时握力低，则诊断为肌肉减少症。痴呆的诊断基于美国国家老龄化研究所和阿尔茨海默病协会标准以及精神障碍诊断与统计手册-第五版中的主要神经认知障碍定义。肌肉力量通过手持测力计测量，身体机能通过 4 米常规步行速度评估。
GC 肌肉厚度和 SMI 与功能参数之间存在相似/中度的相关系数（均 P<0.01）。46 名患者（20.8%）患有痴呆症，其中 21 名（45.7%）通过 GC 厚度诊断为肌肉减少症（P<0.001）。痴呆症患者的年龄较大，但体重、体重指数和所有肌肉减少症相关参数均较低（均 P<0.01）。当将临床变量纳入二项逻辑回归分析时，年龄[OR=1.095（95%可信区间：1.028-1.167）]、体重[OR=0.918（95%可信区间：0.887-0.950）]和痴呆症的存在[OR=5.109（95%可信区间：2.002-13.033）]与通过 GC 肌肉厚度诊断的肌肉减少症（均 P<0.05）独立相关。
本研究表明，痴呆症老年人（45.7%）的肌肉减少症患病率高于无痴呆症老年人（11.4%）。在不同因素中，年龄增加、体重减轻和痴呆症的存在独立增加了通过 GC 肌肉厚度（而不是通过 SMI）诊断的肌肉减少症的风险。因此，我们可以在门诊中通过 US 轻松且成功地评估痴呆症患者的（区域性）肌肉质量损失。
