A Cumulative Muscle Index and Its Parameters for Predicting Future Cognitive Decline: Longitudinal Outcomes of the ASPRA Cohort

Abstract

Sarcopenia and cognitive decline share the major risk factors of physical inactivity; previous studies have shown inconsistent associations. We aimed to identify the association of sarcopenia and its parameters with cognitive decline. The 3-year longitudinal outcomes of 1327 participants from the Aging Study of the Pyeongchang Rural Area (ASPRA) cohort were analyzed. Cognitive performance was evaluated using the Mini-Mental State Examination (MMSE), and sarcopenia was defined by the following: the original and revised Asian Working Group for Sarcopenia (AWGS), the original and revised European Working Group on Sarcopenia in Older People (EWGSOP), and the Cumulative Muscle Index (CMI), a novel index based on the number of impaired domains of sarcopenia. Approximately half of the participants showed meaningful cognitive decline. Sarcopenia by the original EWGSOP and the CMI were associated with cognitive decline. Only the CMI showed consistent predictability for cognitive impairment even with different criteria of the MMSE score (OR 1.23 [1.04–1.46]; OR 1.34 [1.12–1.59]; OR 1.22 [1.01–1.49], using the 1, 2, and 3 cut-off value, respectively). Of the CMI parameters, gait speed was satisfactorily predictive of 3-year cognitive impairment (OR 0.54 [0.30–0.97]). In conclusion, sarcopenia based on the CMI may be predictive of future cognitive impairment. Gait speed was the single most important indicator of cognitive decline.

The Aging Study of Pyeongchang Rural Area (ASPRA): Findings and Perspectives for Human Aging, Frailty, and Disability

“… 31 ) Moreover, among various existing sarcopenic definitions, including the original and revised EWGSOP and the Asian Working Group for Sarcopenia (AWGS), only the SPS predicted future cognitive decline as assessed by the Mini-Mental State Examination (MMSE). 32 ) These results suggest that sarcopenia can be better captured by methods combining incremental sarcopenic burden in a manner similar to that used in the frailty index, rather than by an operational, dichotomous manner of determining sarcopenia.…”

Association of Sarcopenia and Its Defining Components with the Degree of Cognitive Impairment in a Memory Clinic Population

“…A combination of MCI and slow gait speed seems to be a strong predictor of further cognitive deterioration into AD, and is proposed as a subgroup of MCI named motoric cognitive risk syndrome [39]. Moreover, a newly derived sarcopenic index [37] showed that gait speed was the single most important indicator of cognitive decline in community-dwelling older adults [40]. We may speculate that for clinical practice, it could be important to identify motoric cognitive risk syndrome in order to possibly delay or decrease the risk of further cognitive decline with lifestyle interventions [41].…”