McNeish Brendan L, Kunzer Brian, Bell Sarah G, Rosano Caterina
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.
Geroscience. 2025 Sep 5. doi: 10.1007/s11357-025-01857-6.
Cancer is associated with accelerated aging, including changes in muscle composition and cognition. However, the relationship between myosteatosis and cognitive function has not been investigated in older cancer survivors. This study evaluated the association between myosteatosis and cognitive function in this population.
The sample included 75 cancer survivors (age 76-85; 65% men; 31% Black; 41% prostate cancer; 21% breast cancer) from the Health ABC study who developed cancer within the first five years, completed CT imaging at Year 6, and cognitive testing at Year 10. Thigh intermuscular fat area (myosteatosis) was measured by CT at Year 6. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST) and Modified Mini-Mental Status Exam (3MS) at Years 5 and 10. Multivariable models adjusted for demographics, education, cognitive function, and thigh muscle area at Year 5. Sensitivity analyses adjusted for leg strength, race, dementia risk factors, BMI, abdominal visceral fat, and thigh subcutaneous fat. LASSO regression identified key predictors of DSST and 3MS scores.
Greater thigh myosteatosis at Year 6 was associated with lower DSST (B = - 0.212, p < 0.05) and 3MS (B = - 0.145, p < 0.05) scores at Year 10. Associations remained significant after adjustment for strength, dementia risk, and adiposity. LASSO identified race, education, Year 5 cognition, and myosteatosis as key predictors for DSST as well as thigh muscle area and physical activity for 3MS.
Thigh myosteatosis is independently associated with lower cognitive performance in older cancer survivors and may represent a rehabilitation target to improve cognitive outcomes.
癌症与加速衰老有关，包括肌肉组成和认知方面的变化。然而，老年癌症幸存者中肌少脂性与认知功能之间的关系尚未得到研究。本研究评估了该人群中肌少脂性与认知功能之间的关联。
样本包括来自健康ABC研究的75名癌症幸存者（年龄76 - 85岁；65%为男性；31%为黑人；41%为前列腺癌；21%为乳腺癌），他们在头五年内患癌，在第6年完成CT成像，并在第10年进行认知测试。第6年通过CT测量大腿肌间脂肪面积（肌少脂性）。在第5年和第10年使用数字符号替换测试（DSST）和改良简易精神状态检查（3MS）评估认知功能。多变量模型对第5年的人口统计学、教育程度、认知功能和大腿肌肉面积进行了调整。敏感性分析对腿部力量、种族、痴呆风险因素、BMI、腹部内脏脂肪和大腿皮下脂肪进行了调整。LASSO回归确定了DSST和3MS评分的关键预测因素。
第6年大腿肌少脂性程度越高，与第10年较低的DSST（B = - 0.212，p < 0.05）和3MS（B = - 0.145，p < 0.05）评分相关。在对力量、痴呆风险和肥胖进行调整后，关联仍然显著。LASSO确定种族、教育程度、第5年的认知和肌少脂性是DSST的关键预测因素，以及大腿肌肉面积和身体活动是3MS的关键预测因素。
大腿肌少脂性与老年癌症幸存者较低的认知表现独立相关，可能代表了改善认知结果的一个康复目标。
