Weng Xiao-Fen, Liu Shan-Wen, Li Meng, Zhang Yu, Zhang Ying-Chun, Liu Chun-Feng, Zhu Jiang-Tao, Hu Hua
Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of Geriatric Medicine, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Psychogeriatrics. 2023 Nov;23(6):944-953. doi: 10.1111/psyg.13015. Epub 2023 Aug 31.
Previous research has linked sarcopenic obesity (SO) to cognitive function; however, the relationship between cognitive performance and SO Alzheimer's disease (AD) patients remains unclear. This study aimed to investigate their relationship in AD patients.
One hundred and twenty mild to moderate AD patients and 56 normal controls were recruited. According to sarcopenia or obesity status, AD patients were classified into subgroups: normal, obesity, sarcopenia, and SO. Body composition, demographics, and sarcopenia parameters were assessed. Cognitive performance was evaluated using neuropsychological scales.
Among the 176 participants, the prevalence of SO in the moderate AD group was higher than in the normal control group. The moderate AD group had the lowest appendicular skeletal muscle mass index (ASMI) and the highest percentage of body fat (PBF). Hypertension and diabetes were more prevalent in the SO group than in the normal group among the subgroups. The sarcopenia and SO groups exhibited worse global cognitive function compared to the normal and obesity groups. Partial correlation analysis revealed that ASMI, PBF, and visceral fat area were associated with multiple cognitive domains scores. In logistic regression analysis, after adjusting for confounders, obesity was not found to be associated with AD. However, sarcopenia (odds ratio (OR) = 5.35, 95% CI: 1.27-22.46) and SO (OR = 5.84, 95% CI: 1.26-27.11) were identified as independent risk factors for AD.
SO was associated with cognitive dysfunction in AD patients. Moreover, the impact of SO on cognitive decline was greater than that of sarcopenia. Early identification and intervention for SO may have a positive effect on the occurrence and progression of AD.
先前的研究已将肌少症性肥胖（SO）与认知功能联系起来；然而，认知表现与SO型阿尔茨海默病（AD）患者之间的关系仍不清楚。本研究旨在调查AD患者中它们之间的关系。
招募了120例轻度至中度AD患者和56名正常对照者。根据肌少症或肥胖状况，将AD患者分为亚组：正常组、肥胖组、肌少症组和SO组。评估身体成分、人口统计学特征和肌少症参数。使用神经心理量表评估认知表现。
在176名参与者中，中度AD组中SO的患病率高于正常对照组。中度AD组的四肢骨骼肌质量指数（ASMI）最低，体脂百分比（PBF）最高。在各亚组中，SO组的高血压和糖尿病患病率高于正常组。与正常组和肥胖组相比，肌少症组和SO组的整体认知功能较差。偏相关分析显示，ASMI、PBF和内脏脂肪面积与多个认知领域得分相关。在逻辑回归分析中，调整混杂因素后，未发现肥胖与AD相关。然而，肌少症（优势比（OR）=5.35，95%置信区间：1.27 - 22.46）和SO（OR = 5.84，95%置信区间：1.26 - 27.11）被确定为AD的独立危险因素。
SO与AD患者的认知功能障碍相关。此外，SO对认知衰退的影响大于肌少症。对SO进行早期识别和干预可能对AD的发生和进展产生积极影响。
