Shi Yin, Zhang Yu, Yang Xinyu, Yang Jiali, Wang Shilang, Hong YanFang
Department of Critical Care Medicine, Deqing People's Hospital, Huzhou, Zhejiang, China.
College of Medical Science, Huzhou University, Zhejiang, China.
Front Psychiatry. 2025 Jun 3;16:1595625. doi: 10.3389/fpsyt.2025.1595625. eCollection 2025.
BACKGROUND: Sarcopenia is the main cause of disability in an aging society and increases the risk of death in older adults. However, the relationship between cognitive function and muscle mass and the underlying mechanisms are not clear. This study aims to investigate the relationship between cognitive function and muscle mass in the older adults. METHODS: This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS), phase III from 2011 to 2018. We analyzed 2536 participants aged ≥60 years. SPSS 27.0 software was used for data screening and statistical analysis, and MPLUS 8.7 and R4.4.2 software were used to construct cross-lag models and restricted cubic splints. RESULTS: In this study, out of 2,536 participants, there were 1,283 males (50.6%) and 1,253 females (49.4%), with an average age of 77.54 ± 8.6 years. Correlation analysis showed that cognitive function was positively correlated with muscle mass in older adults. At all time points (<0.05). The cross-lag model revealed a one-way prediction effect: The path coefficients of ASMI→MMSE in T1→T2 and T2→T3 were statistically significant in the general population, men and women (<0.05), and the path coefficients were all greater than 0. The association of MMSE → ASMI was significant only at the T2 → T3 time point in the overall population (β = 0.010, P < 0.05), and not statistically significant at T1 → T2 and T2 → T3 time points in both males and females (P <0.05). RCS results showed that the association between skeletal muscle mass and cognitive impairment in the total population ( 0.05, 0.05), older men ( 0.05, 0.05) and older women ( 0.05, 0.05) showed a nonlinear increasing trend. It is suggested that ASMI should be maintained at 7.45kg/m and 5.68kg/m or above in older men and women, respectively. CONCLUSION: Muscle mass had a major predictive effect on cognitive trajectory, especially in females. Maintaining ASMI above gender-specific thresholds may help slow cognitive decline, suggesting that muscle mass can serve as an adjustable biomarker for dementia prevention. Longitudinal studies should verify the validity of these thresholds in different populations.
背景：肌肉减少症是老龄化社会中残疾的主要原因，并增加了老年人的死亡风险。然而，认知功能与肌肉量之间的关系及其潜在机制尚不清楚。本研究旨在调查老年人认知功能与肌肉量之间的关系。 方法：本研究基于中国老年健康长寿纵向调查（CLHLS），2011年至2018年的第三阶段。我们分析了2536名年龄≥60岁的参与者。使用SPSS 27.0软件进行数据筛选和统计分析，使用MPLUS 8.7和R4.4.2软件构建交叉滞后模型和受限立方样条。 结果：在本研究的2536名参与者中，男性1283名（50.6%），女性1253名（49.4%），平均年龄为77.54±8.6岁。相关性分析表明，老年人的认知功能与肌肉量呈正相关。在所有时间点（<0.05）。交叉滞后模型显示出单向预测效应：在总体人群、男性和女性中，T1→T2和T2→T3时ASMI→MMSE的路径系数具有统计学意义（<0.05），且路径系数均大于0。MMSE→ASMI的关联仅在总体人群的T2→T3时间点具有统计学意义（β=0.010，P<0.05），在男性和女性的T1→T2和T2→T3时间点均无统计学意义（P<0.05）。RCS结果显示，总体人群（P<0.05）、老年男性（P<0.05）和老年女性（P<0.05）中骨骼肌量与认知障碍之间的关联呈非线性增加趋势。建议老年男性和女性的ASMI分别维持在7.45kg/m和5.68kg/m或以上。 结论：肌肉量对认知轨迹有主要预测作用，尤其是在女性中。将ASMI维持在特定性别的阈值以上可能有助于减缓认知衰退，这表明肌肉量可作为预防痴呆的一个可调节生物标志物。纵向研究应验证这些阈值在不同人群中的有效性。
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