Relationship Between Sarcopenia and Cognitive Function in Community-Dwelling Older Adults

Abstract

Objectives: Sarcopenia, known as muscle bulk and strength loss, along with cognitive impairment, are frequently observed in the aging population. Although both conditions are prevalent, their potential interplay has not yet been clearly defined. It was aimed to explore the link between sarcopenia and cognitive functions in the older adult population. Materials and Methods: Fifty-five older adults with an average age of 73.34 ± 6.65 participated in the study. While cognitive functions were examined using the Mini-Mental State Examination (MMSE), the risk of sarcopenia was determined using the Sarcopenia Screening Questionnaire (SARC-F). Additionally, functional mobility and hand grip strength were measured using the “Timed Up and Go (TUG)” test and the “Four-Meter Walk Test”. Results: Of the participants, 56.4% exhibited cognitive impairment, and 52.7% were at risk of sarcopenia. Correlation analysis revealed significant relationships between MMSE scores and SARC-F (r=-0.741), dominant (r=0.577) and non-dominant grip strength (r=0.549), the TUG test (r=-0.714), and the Four-Meter Walk Test (r=-0.752) (p<0.001). Conclusion: The findings underline the value of incorporating assessments of both sarcopenia and cognitive function in the comprehensive evaluation of older adults.

Keywords

• congition
• older adults
• sarcopenia

References

1. Abellan van Kan, G., Rolland, Y., Gillette-Guyonnet, S., Gardette, V., Annweiler, C., Beauchet, O., Andrieu, S., & Vellas, B. (2012). Gait speed, body composition, and dementia. The EPIDOS-Toulouse cohort. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 67(4), 425-432. https://doi.org/10.1093/gerona/glr177
2. Bahat, G., Tufan, A., Tufan, F., Kilic, C., Akpinar, T. S., Kose, M., Erten, N., Karan, M. A., & Cruz-Jentoft, A. J. (2016). Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clinical Nutrition, 35(6), 1557-1563. https://doi.org/10.1016/j.clnu.2016.02.002
3. Bahat, G., Yilmaz, O., Kilic, C., Oren, M., & Karan, M. (2018). Performance of SARC-F in regard to sarcopenia definitions, muscle mass and functional measures. The journal of Nutrition, Health & Aging, 22, 898-903. https://doi.org/10.1007/s12603-018-1067-8
4. Baumgart, M., Snyder, H. M., Carrillo, M. C., Fazio, S., Kim, H., & Johns, H. (2015). Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimer's & Dementia, 11(6), 718-726. https://doi.org/10.1016/j.jalz.2015.05.016
5. Beaudart, C., Demonceau, C., Reginster, J. Y., Locquet, M., Cesari, M., Cruz Jentoft, A. J., & Bruyère, O. (2023). Sarcopenia and health‐related quality of life: A systematic review and meta‐analysis. Journal of Cachexia, Sarcopenia and Muscle. https://doi.org/10.1002/jcsm.13243
6. Beeri, M. S., Leugrans, S. E., Delbono, O., Bennett, D. A., & Buchman, A. S. (2021). Sarcopenia is associated with incident Alzheimer's dementia, m ild cognitive impairment, and cognitive decline. Journal of the American Geriatrics Society, 69(7), 1826-1835. https://doi.org/10.1111/jgs.17206
7. Bruyère, O., Beaudart, C., Reginster, J.-Y., Buckinx, F., Schoene, D., Hirani, V., Cooper, C., Kanis, J. A., Rizzoli, R., & McCloskey, E. (2016). Assessment of muscle mass, muscle strength and physical performance in clinical practice: an international survey. European Geriatric Medicine, 7(3), 243-246. https://doi.org/10.1016/j.eurger.2015.12.009
8. Chang, K.-V., Hsu, T.-H., Wu, W.-T., Huang, K.-C., & Han, D.-S. (2016). Association between sarcopenia and cognitive impairment: a systematic review and meta-analysis. Journal of the American Medical Directors Association, 17(12), 1164. e1167-1164. e1115. https://doi.org/10.1016/j.jamda.2016.09.013

9. Chen, X., Cao, M., Liu, M., Liu, S., Zhao, Z., & Chen, H. (2022). Association between sarcopenia and cognitive impairment in the older people: a meta-analysis. European Geriatric Medicine, 13(4), 771-787. https://doi.org/10.1007/s41999-022-00661-1
10. Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., & Sayer, A. A. (2019). Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16-31. https://doi.org/10.1093/ageing/afy169
11. Çebi, M., Babacan, G., Öktem Tanör, Ö., & Gürvit, H. (2020). Discrimination ability of the Short Test of Mental Status (STMS) compared to the Mini Mental State Examination (MMSE) in the spectrum of normal cognition, mild cognitive impairment, and probable Alzheimer’s disease dementia: the Turkish standardization study. Journal of Clinical and Experimental Neuropsychology, 42(5), 450-458. https://doi.org/10.1080/13803395.2020.1758633
12. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. https://doi.org/10.1016/0022-3956(75)90026-6
13. Ganmore, I., Elkayam, I., Ravona-Springer, R., Lin, H.-M., Liu, X., Plotnik, M., Buchman, A. S., Berman, Y., Schwartz, J., & Sano, M. (2020). Deterioration in motor function over time in older adults with type 2 diabetes is associated with accelerated cognitive decline. Endocrine Practice, 26(10), 1143-1152. https://doi.org/10.4158/EP-2020-0289
14. Gogtay, N. J., & Thatte, U. M. (2017). Principles of correlation analysis. Journal of the Association of Physicians of India, 65, 78-81.
15. Güngen, C., Ertan, T., Eker, E., Yaşar, R., & Engin, F. (2002). Standardize mini mental test’in Türk toplumunda hafif demans tan› s› nda geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi, 13(4), 273-281.
16. Halil, M., Ulger, Z., Varlı, M., Döventaş, A., Oztürk, G., Kuyumcu, M., Yavuz, B., Yesil, Y., Tufan, F., & Cankurtaran, M. (2014). Sarcopenia assessment project in the nursing homes in Turkey. European Journal of Clinical Nutrition, 68(6), 690-694. https://doi.org/10.1038/ejcn.2014.15
17. Hallgren, M., Herring, M. P., Owen, N., Dunstan, D., Ekblom, Ö., Helgadottir, B., Nakitanda, O. A., & Forsell, Y. (2016). Exercise, physical activity, and sedentary behavior in the treatment of depression: broadening the scientific perspectives and clinical opportunities. Frontiers in Psychiatry, 7, 36. https://doi.org/10.3389/fpsyt.2016.00036
18. Hu, Y., Peng, W., Ren, R., Wang, Y., & Wang, G. (2022). Sarcopenia and mild cognitive impairment among elderly adults: the first longitudinal evidence from CHARLS. Journal of Cachexia, Sarcopenia and Muscle, 13(6), 2944-2952. https://doi.org/10.1002/jcsm.13081
19. Huang, C.-Y., Hwang, A.-C., Liu, L.-K., Lee, W.-J., Chen, L.-Y., Peng, L.-N., Lin, M.-H., & Chen, L.-K. (2016). Association of dynapenia, sarcopenia, and cognitive impairment among community-dwelling older Taiwanese. Rejuvenation Research, 19(1), 71-78. https://doi.org/10.1089/rej.2015.1710
20. Jia, X., Wang, Z., Huang, F., Su, C., Du, W., Jiang, H., Wang, H., Wang, J., Wang, F., & Su, W. (2021). A comparison of the Mini-Mental State Examination (MMSE) with the Montreal Cognitive Assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study. BMC Psychiatry, 21, 1-13. https://doi.org/10.1186/s12888-021-03495-6
21. Kalaria, R. N. (2016). Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for Alzheimer’s disease. Acta Neuropathologica, 131(5), 659-685. https://doi.org/10.1007/s00401-016-1571-z
22. Kaplan, H. I., & Sadock, B. J. (1988). Synopsis of psychiatry: Behavioral sciences clinical psychiatry. Williams & Wilkins Co. https://doi.org/10.1097/00004850-198904000-00007
23. Li, X., Peng, A., Li, L., & Chen, L. (2023). Association between walking and square dancing-oriented leisure-time physical activity and cognitive function among middle-aged and elderly people in Southwest China. BMC Geriatrics, 23(1), 28. https://doi.org/10.1186/s12877-023-03737-0
24. Molino, S., Dossena, M., Buonocore, D., & Verri, M. (2016). Sarcopenic obesity: an appraisal of the current status of knowledge and management in elderly people. The Journal of Nutrition, Health and Aging, 20(7), 780-788. https://doi.org/10.1007/s12603-015-0631-8
25. Morley, J. E., Abbatecola, A. M., Argiles, J. M., Baracos, V., Bauer, J., Bhasin, S., Cederholm, T., Coats, A. J. S., Cummings, S. R., & Evans, W. J. (2011). Sarcopenia with limited mobility: an international consensus. Journal of the American Medical Directors Association, 12(6), 403-409. https://doi.org/10.1016/j.jamda.2011.04.014
26. Ogawa, Y., Kaneko, Y., Sato, T., Shimizu, S., Kanetaka, H., & Hanyu, H. (2018). Sarcopenia and muscle functions at various stages of Alzheimer disease. Frontiers in Neurology, 9, 710. https://doi.org/10.3389/fneur.2018.00710
27. Peng, T.-C., Chen, W.-L., Wu, L.-W., Chang, Y.-W., & Kao, T.-W. (2020). Sarcopenia and cognitive impairment: A systematic review and meta-analysis. Clinical Nutrition, 39(9), 2695-2701. https://doi.org/10.1016/j.clnu.2019.12.014
28. Podsiadlo, D., & Richardson, S. (1991). The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
29. Rosso, A. L., Studenski, S. A., Chen, W. G., Aizenstein, H. J., Alexander, N. B., Bennett, D. A., Black, S. E., Camicioli, R., Carlson, M. C., & Ferrucci, L. (2013). Aging, the central nervous system, and mobility. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 68(11), 1379-1386. https://doi.org/10.1093/gerona/glt089
30. Sahin, U. K., Tozluoglu, E. Y., Durdu, H., Korkmaz, N., Bahar, N. T., & Yavuz, E. (2022). Screening for frailty and sarcopenia in community-dwelling older adults: a cross-sectional study from the Eastern Black Sea region of Turkey. Aging Clinical and Experimental Research, 34(9), 2047-2056. https://doi.org/10.1007/s40520-022-02164-2
31. Sakuma, N., Ura, C., Miyamae, F., Inagaki, H., Ito, K., Niikawa, H., Ijuin, M., Okamura, T., Sugiyama, M., & Awata, S. (2017). Distribution of Mini‐Mental State Examination scores among urban community‐dwelling older adults in Japan. International Journal of Geriatric Psychiatry, 32(7), 718-725. https://doi.org/10.1002/gps.4513
32. Scisciola, L., Fontanella, R. A., Surina, Cataldo, V., Paolisso, G., & Barbieri, M. (2021). Sarcopenia and cognitive function: role of myokines in muscle brain cross-talk. Life, 11(2), 173. https://doi.org/10.3390/life11020173
33. Singh-Manoux, A., Dugravot, A., Kauffmann, F., Elbaz, A., Ankri, J., Nabi, H., Kivimaki, M., & Sabia, S. (2011). Association of lung function with physical, mental and cognitive function in early old age. Age, 33, 385-392. https://doi.org/10.1007/s11357-010-9189-x
34. Sugimoto, T., Ono, R., Murata, S., Saji, N., Matsui, Y., Niida, S., Toba, K., & Sakurai, T. (2016). Prevalence and associated factors of sarcopenia in elderly subjects with amnestic mild cognitive impairment or Alzheimer disease. Current Alzheimer Research, 13(6), 718-726. https://doi.org/10.2174/1567205013666160211124828
35. Szlejf, C., Suemoto, C. K., Lotufo, P. A., & Benseñor, I. M. (2019). Association of sarcopenia with performance on multiple cognitive domains: results from the ELSA-Brasil study. The Journals of Gerontology: Series A, 74(11), 1805-1811. https://doi.org/10.1093/gerona/glz118
36. Tolea, M. I., & Galvin, J. E. (2015). Sarcopenia and impairment in cognitive and physical performance. Clinical Interventions in Aging, 663-671. https://doi.org/10.2147/CIA.S76275
37. Urzi, F., Šimunič, B., & Buzan, E. (2017). Basis for sarcopenia screening with the SARC-CalF in nursing homes. Journal of the American Medical Directors Association, 18(11), 991. e995-991. e910. https://doi.org/10.1016/j.jamda.2017.07.011
38. Walston, J. D. (2012). Sarcopenia in older adults. Current opinion in Rheumatology, 24(6), 623. https://doi.org/10.1097/BOR.0b013e328358d59b
39. Yamada, M., Nishiguchi, S., Fukutani, N., Tanigawa, T., Yukutake, T., Kayama, H., Aoyama, T., & Arai, H. (2013). Prevalence of sarcopenia in community-dwelling Japanese older adults. Journal of the American Medical Directors Association, 14(12), 911-915. https://doi.org/10.1016/j.jamda.2013.08.015
40. Yang, M., Hu, X., Xie, L., Zhang, L., Zhou, J., Lin, J., Wang, Y., Li, Y., Han, Z., & Zhang, D. (2018). Screening sarcopenia in community-dwelling older adults: SARC-F vs SARC-F combined with calf circumference (SARC-CalF). Journal of the American Medical Directors Association, 19(3), 277. e271-277. e278. https://doi.org/10.1016/j.jamda.2017.12.016
41. Yu, L., Boyle, P. A., Leurgans, S. E., Wilson, R. S., Bennett, D. A., & Buchman, A. S. (2019). Incident mobility disability, mild cognitive impairment, and mortality in community-dwelling older adults. Neuroepidemiology, 53(1-2), 55-62. https://doi.org/10.1159/000499334
42. Yuan, S., & Larsson, S. C. (2023). Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism, 155533. https://doi.org/10.1016/j.metabol.2023.155533
43. Yücel, S. D., Şahin, F., Doğu, B., Şahin, T., Kuran, B., & Gürsakal, S. (2012). Reliability and validity of the Turkish version of the Performance-Oriented Mobility Assessment I. European Review of Aging and Physical Activity, 9(2), 149-159. https://doi.org/10.1007/s11556-012-0096-2