John Sealy School of Medicine, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA.
Department of Population Health and Health Disparities, School of Public and Population Health, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA; Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA; Sealy Center on Aging, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA.
Clin Nutr ESPEN. 2024 Oct;63:191-196. doi: 10.1016/j.clnesp.2024.06.039. Epub 2024 Jun 26.
BACKGROUND & AIMS: Dynapenia and obesity have been independently associated with cognitive decline in older adults, but their co-occurring effects has not been well-studied. The study objective is to examine the relationship between dynapenic-obesity and cognitive impairment in older adults 75 years and older with normal or high cognitive function at baseline over 12 years of follow-up. We hypothesize that those with dynapenic obesity will have greater odds of cognitive function impairment than those with dynapenia only, obesity only, or no dynapenia no obesity (reference group).
A total of 761 participants with a mean age of 81.5 and Mini-Mental State Examination (MMSE) > 21 at baseline were divided into four groups: no dynapenia no obesity (n = 316), obesity only (n = 142), dynapenia only (n = 217), and dynapenic obesity (n = 86). Measures included socio-demographics, medical conditions, body mass index, depressive symptoms, handgrip strength, and limitations in activities of daily living. We performed a mixed models estimate for cognitive decline for these groups over a 12-year period. Handgrip strength (HGS) was measured with a handgrip dynamometer and cognitive function was assessed with MMSE.
Participants in the dynapenia-obesity group experienced a greater (β = - 1.29, Standard Error = 0.60, p-value = 0.0316) cognitive decline over time compared to those in the no dynapenia and no obesity group, after controlling for all covariates.
Older adults with dynapenic-obesity were at high risk of cognitive decline over time. These findings highlight the need for interventions that target both conditions in this population to help maintain cognitive health. Community-based strength training programs and educational initiatives on nutrition and diet can help older adults reduce their risk of age-related cognitive decline.
衰弱和肥胖症已被独立证明与老年人认知能力下降有关,但它们共同的影响尚未得到充分研究。本研究的目的是在 12 年的随访中,检查基线时认知功能正常或较高的 75 岁及以上老年人中,衰弱合并肥胖与认知障碍之间的关系。我们假设,与仅衰弱、仅肥胖或无衰弱无肥胖(参照组)相比,患有衰弱合并肥胖症的老年人认知功能障碍的可能性更大。
共有 761 名平均年龄为 81.5 岁、基线时 Mini-Mental State Examination(MMSE)>21 的参与者被分为四组:无衰弱无肥胖(n=316)、单纯肥胖(n=142)、单纯衰弱(n=217)和衰弱合并肥胖(n=86)。研究措施包括社会人口统计学、医疗状况、体重指数、抑郁症状、手握力和日常生活活动受限。我们对这些组在 12 年内的认知能力下降进行了混合模型估计。手握力(HGS)使用握力计进行测量,认知功能使用 MMSE 进行评估。
在控制所有协变量后,与无衰弱和无肥胖组相比,衰弱合并肥胖组参与者随着时间的推移认知能力下降幅度更大(β=-1.29,标准误差=0.60,p 值=0.0316)。
患有衰弱合并肥胖症的老年人随着时间的推移认知能力下降的风险较高。这些发现强调了针对该人群中这两种情况的干预措施的必要性,以帮助维持认知健康。基于社区的力量训练计划和营养与饮食方面的教育举措可以帮助老年人降低与年龄相关的认知能力下降的风险。