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使用不同肥胖定义时中国老年人肌少性肥胖与痴呆症之间的关联:来自中国健康与养老追踪调查(CHARLS)的证据

Association between sarcopenic obesity and dementia in the Chinese elderly using different definitions of obesity: evidence from the CHARLS.

作者信息

Peng Lang, Xiang Qingwei, Jia Ge, Yin Renyi

机构信息

Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China.

Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China.

出版信息

Front Aging Neurosci. 2025 Jun 4;17:1540272. doi: 10.3389/fnagi.2025.1540272. eCollection 2025.


DOI:10.3389/fnagi.2025.1540272
PMID:40535512
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12174056/
Abstract

OBJECTIVES: The prevalence of sarcopenic obesity, characterized by the coexistence of reduced muscle mass and function alongside increased adipose tissue, is increasing in the aging population. This study aims to investigate the association between sarcopenic obesity and dementia risk in community-dwelling older adults in China, utilizing a nationally representative dataset. Furthermore, we aim to assess the comparative effectiveness of waist circumference versus body mass index as indicators for assessing this risk association. DESIGN: The study was designed as a cross-sectional study. SETTING AND PARTICIPANTS: Based on the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS) 2015, a total of 5,320 community-dwelling participants aged 60 years and above were categorized into four groups according to their respective classifications of normal status, possible sarcopenia, obesity, and sarcopenic obesity. METHODS: Multivariable logistic regression models were used to analyze the relationship between sarcopenic obesity and probable dementia while adjusting for potential confounders. RESULTS: After adjusting for potential confounders, possible sarcopenia alone ( 1.674, 1.238-2.264) and sarcopenic obesity ( 1.812, 1.325-2.479) were significantly associated with an increased risk of probable dementia. In contrast, abdominal obesity alone, defined by waist circumference (WC), was not significantly associated with dementia risk. When stratified by age and gender, the association between sarcopenic obesity and probable dementia remained significant. CONCLUSION AND IMPLICATIONS: The findings from this cross-sectional study suggest that both possible sarcopenia and sarcopenic obesity are significantly associated with an increased risk of probable dementia among older adults residing in the community in China. Notably, the relationship between sarcopenic obesity and dementia appears to be more pronounced compared to either possible sarcopenia or obesity alone. Moreover, incorporating waist circumference alongside components of possible sarcopenia may serve as a more effective predictor of cognitive impairment when compared to relying solely on body mass index (BMI). These results underscore the critical importance of early identification and intervention for individuals with sarcopenic obesity to mitigate the risk of developing dementia.

摘要

目的:肌肉减少性肥胖的特点是肌肉量和功能下降同时脂肪组织增加,在老年人群中的患病率正在上升。本研究旨在利用具有全国代表性的数据集,调查中国社区居住的老年人中肌肉减少性肥胖与痴呆风险之间的关联。此外,我们旨在评估腰围与体重指数作为评估这种风险关联指标的相对有效性。 设计:本研究设计为横断面研究。 设置和参与者:基于2015年中国健康与养老追踪调查(CHARLS)具有全国代表性的数据,共有5320名60岁及以上的社区居住参与者根据其正常状态、可能的肌肉减少症、肥胖症和肌肉减少性肥胖的各自分类被分为四组。 方法:使用多变量逻辑回归模型分析肌肉减少性肥胖与可能的痴呆之间的关系,同时调整潜在的混杂因素。 结果:在调整潜在混杂因素后,仅可能的肌肉减少症(比值比1.674,95%置信区间1.238 - 2.264)和肌肉减少性肥胖(比值比1.812,95%置信区间1.325 - 2.479)与可能的痴呆风险增加显著相关。相比之下,仅由腰围(WC)定义的腹部肥胖与痴呆风险无显著关联。按年龄和性别分层时,肌肉减少性肥胖与可能的痴呆之间的关联仍然显著。 结论和启示:这项横断面研究的结果表明,在中国社区居住的老年人中,可能的肌肉减少症和肌肉减少性肥胖均与可能的痴呆风险增加显著相关。值得注意的是,与单独的可能的肌肉减少症或肥胖症相比,肌肉减少性肥胖与痴呆之间的关系似乎更为明显。此外,与仅依靠体重指数(BMI)相比,将腰围与可能的肌肉减少症成分结合起来可能是认知障碍的更有效预测指标。这些结果强调了对肌肉减少性肥胖个体进行早期识别和干预以降低患痴呆风险的至关重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bf/12174056/bc77e294b345/fnagi-17-1540272-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bf/12174056/7ae47ce21d5f/fnagi-17-1540272-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bf/12174056/bc77e294b345/fnagi-17-1540272-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bf/12174056/7ae47ce21d5f/fnagi-17-1540272-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40bf/12174056/bc77e294b345/fnagi-17-1540272-g002.jpg

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本文引用的文献

[1]
Association of obesity indicators with cognitive function among US adults aged 60 years and older: Results from NHANES.

Brain Behav. 2024-9

[2]
Prevalence and Influencing Factors of Central Obesity among Adults in China: China Nutrition and Health Surveillance (2015-2017).

Nutrients. 2024-8-9

[3]
Projection for dementia burden in China to 2050: a macro-simulation study by scenarios of dementia incidence trends.

Lancet Reg Health West Pac. 2024-7-30

[4]
Low handgrip strength with asymmetry is associated with elevated all-cause mortality risk in older Chinese adults with abdominal obesity.

PLoS One. 2024

[5]
Dynamic Features of Body Mass Index in Late Life Predict Cognitive Trajectories and Alzheimer's Disease: A Longitudinal Study.

J Alzheimers Dis. 2024

[6]
The diagnostic agreement of sarcopenic obesity with different definitions in Chinese community-dwelling middle-aged and older adults.

Front Public Health. 2024

[7]
Body Composition, Sarcopenic Obesity, and Cognitive Function in Older Adults: Findings From the National Health and Nutrition Examination Survey (NHANES) 1999-2002 and 2011-2014.

J Am Nutr Assoc. 2024-8

[8]
Sarcopenic obesity is part of obesity paradox in dementia development: evidence from a population-based cohort study.

BMC Med. 2024-3-22

[9]
Population-level interventions for the primary prevention of dementia: a complex evidence review.

EClinicalMedicine. 2024-3-10

[10]
Associations between sarcopenic obesity and risk of cardiovascular disease: A population-based cohort study among middle-aged and older adults using the CHARLS.

Clin Nutr. 2024-3

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