Huang Jiahui, Li Min, Luo Qiangqiang, Li Jing
School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China.
PLoS One. 2025 May 28;20(5):e0324258. doi: 10.1371/journal.pone.0324258. eCollection 2025.
The study aimed to investigate the relationship between sarcopenia, possible sarcopenia, and cognitive impairment, and to analyze the impact of potential moderating factors.
A comprehensive search was conducted on PubMed, EmBase, Web of Science, Cochrane Library, CNKI, Wanfang Databases, VIP and SinoMed from inception until March 2025. The quality of cross-sectional studies was assessed using the Agency for Healthcare Research and Quality Scale, while the Newcastle-Ottawa scale was used to assess the quality of included case-control and cohort studies. Subgroup analyses and meta-regression were employed to explore potential moderating variables and heterogeneity.
A total of 31 studies were included in this systematic review, of which 27 studies were quantitatively analyzed. The meta-analysis revealed that both sarcopenia and possible sarcopenia significantly associated with cognitive impairment (OR=1.88, 95%CI = 1.71-2.08), (OR=1.96, 95%CI = 1.50-2.58). Subgroup analyses revealed a stronger association between sarcopenia and cognitive impairment in specific demographics: among females with sarcopenia (OR=3.22, 95%CI = 1.23-8.40), in Asian populations (OR=1.96, 95%CI = 1.76-2.18), and within hospital settings (OR=3.12, 95%CI = 2.18-4.48). These findings underscore the influence of gender, ethnicity, and healthcare environment on the relationship between sarcopenia and cognitive impairment. An assessment of publication bias within studies providing adjusted odds ratios indicated potential bias. However, sensitivity analyses and trim-and-filling analyses confirmed the robustness of our findings, suggesting that the observed associations remain reliable despite the presence of publication bias.
Individuals with sarcopenia or possible sarcopenia have approximately twice the odds of developing cognitive impairment compared to those without sarcopenia. Implementing systematic screening and targeted interventions for possible sarcopenia patients is essential to prevent from cognitive decline. Specifically, healthcare professionals should focus on women and inpatients with sarcopenia, employing proactive measures to avert cognitive impairment.
本研究旨在探讨肌肉减少症、疑似肌肉减少症与认知障碍之间的关系，并分析潜在调节因素的影响。
从数据库建库至2025年3月，对PubMed、EmBase、Web of Science、Cochrane图书馆、中国知网、万方数据库、维普数据库和中国生物医学文献数据库进行全面检索。采用美国医疗保健研究与质量局量表评估横断面研究的质量，同时使用纽卡斯尔-渥太华量表评估纳入的病例对照研究和队列研究的质量。采用亚组分析和meta回归探讨潜在的调节变量和异质性。
本系统评价共纳入31项研究，其中27项研究进行了定量分析。meta分析显示，肌肉减少症和疑似肌肉减少症均与认知障碍显著相关（OR=1.88，95%CI=1.71-2.08），（OR=1.96，95%CI=1.50-2.58）。亚组分析显示，在特定人群中，肌肉减少症与认知障碍之间的关联更强：在患有肌肉减少症的女性中（OR=3.22，95%CI=1.23-8.40），在亚洲人群中（OR=1.96，95%CI=1.76-2.18），以及在医院环境中（OR=3.12，95%CI=2.18-4.48）。这些发现强调了性别、种族和医疗环境对肌肉减少症与认知障碍之间关系的影响。对提供调整后比值比的研究进行的发表偏倚评估表明存在潜在偏倚。然而，敏感性分析和修剪填充分析证实了我们研究结果的稳健性，表明尽管存在发表偏倚，但观察到的关联仍然可靠。
与没有肌肉减少症的个体相比，患有肌肉减少症或疑似肌肉减少症的个体发生认知障碍的几率大约是其两倍。对疑似肌肉减少症患者实施系统筛查和针对性干预对于预防认知衰退至关重要。具体而言，医疗保健专业人员应关注患有肌肉减少症的女性和住院患者，采取积极措施避免认知障碍。
