Associations of fat mass and muscle function but not lean mass with cognitive impairment: The Yishun Study

Abstract

Background Sarcopenia and obesity are reportedly associated with risk of cognitive decline, and sarcopenic obesity (SO) heightens the risk, but the evidence is sparse and inconclusive. This study aimed to examine the association between SO and cognitive impairment. Methods A total of 542 community-dwelling adults aged between 21 and 90 years were recruited. All participants were assessed for body composition (dual X-ray absorptiometry), handgrip strength (HGS), gait speed (GS), and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status). Sarcopenia was defined by the presence of low appendicular lean mass index (ALMI) and low HGS or low GS according to the 2019 Asian Working Group for Sarcopenia criteria, and obesity was defined based on the upper two quintiles of fat mass index (FMI). Results Sarcopenia alone or in combination with obesity were not significantly associated with cognitive impairment after controlling for confounding variables. Obesity on its own was significantly associated with greater odds of impaired attention (OR: 2.05, 95%CI 1.12–3.82). Low ALMI was not associated, but low HGS, slow GS, and high FMI were individually associated with cognitive impairment: low HGS and immediate memory (OR: 1.91, 95% CI 1.04–3.49); low GS and immediate memory (OR: 2.17, 95% CI 1.26–3.72); high FMI and attention (OR: 2.06, 95% CI 1.22–3.51). Co-occurring high FMI with either low HGS or slow GS exacerbated the observed odds of global and domain-specific (attention, visuospatial) cognitive impairment. Conclusions Lean mass is not relevant, whereas muscle strength and physical performance or adiposity are relevant in defining sarcopenia or sarcopenic obesity in terms of their cognitive impacts.

Prevalence of nutrition disorders and nutrition‐related conditions in older patients with Alzheimer's disease

“…In a longitudinal cohort study, the baseline prevalence of sarcopenic obesity was 12.9%, which is similar to our study 44 . Sarcopenia and sarcopenic obesity were both associated with dementia diagnoses in that study 44 ; on the other hand, in a different study, sarcopenic obesity was not associated with cognitive functions after adjusting for age, sex, and education 45 …”

“…44 Sarcopenia and sarcopenic obesity were both associated with dementia diagnoses in that study 44 ; on the other hand, in a different study, sarcopenic obesity was not associated with cognitive functions after adjusting for age, sex, and education. 45 Thirty percent of the patients in the obese group had sarcopenia, and 50% had malnutrition in our study. Given that sarcopenia and malnutrition are not protected by fat, obese patients may go undiagnosed for these two conditions.…”

Associations of sarcopenic obesity vs either sarcopenia or obesity alone with cognitive impairment risk in patients requiring maintenance hemodialysis

“…Indeed, several studies have reported that SO is associated with a significantly higher risk of CI compared with sarcopenia or obesity alone in older community‐dwelling individuals 10 . However, these associations were not observed in community‐dwelling adults according to a recent study 11 . The association between SO and CI risk may vary in different populations and need to be ascertained in MHD patients due to the lack of previous studies in this population.…”

Musculoskeletal Deficits and Cognitive Impairment: Epidemiological Evidence and Biological Mechanisms

“…Sarcopenia obesity and sarcopenia alone were significantly associated with higher risk of cognitive impairment. On the other hand, a study including 542 participants 21-90 years recruited from the Chinese community produced contrasting findings [50]. The researchers obtained body composition data using dual-energy x-ray absorptiometry (DXA) and defined obesity as the upper two quintiles of fat mass index.…”