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Sarcopenia and impairment in cognitive and physical performance.

Tolea MI, Galvin JE - Clin Interv Aging (2015)

Bottom Line: Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female) were recruited and underwent physical functionality, anthropometry, and cognitive testing.Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2), physical impairment (Mini Physical Performance Test <12), both, or neither by ordinal logistic regression.The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass.

View Article: PubMed Central - PubMed

Affiliation: Alzheimer's Disease Center, Department of Neurology, New York University School of Medicine, New York, NY, USA.

ABSTRACT

Background: Whether older adults with sarcopenia who underperform controls on tests of physical performance and cognition also have a higher likelihood of combined cognitive-physical impairment is not clear. We assessed the impact of sarcopenia on impairment in both aspects of functionality and the relative contribution of its components, muscle mass and strength.

Methods: Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female) were recruited and underwent physical functionality, anthropometry, and cognitive testing. Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2), physical impairment (Mini Physical Performance Test <12), both, or neither by ordinal logistic regression.

Results: Compared to controls, those with sarcopenia were six times more likely to have combined cognitive impairment/physical impairment with a fully adjusted model showing a three-fold increased odds ratio. The results were consistent across different measures of global cognition (odds ratio =3.46, 95% confidence interval =1.07-11.45 for the Montreal Cognitive Assessment; odds ratio =3.61, 95% confidence interval =1.11-11.72 for Ascertaining Dementia 8). Pre-sarcopenic participants were not different from controls. The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass.

Conclusion: Individuals with sarcopenia are not only more likely to have single but also to have dual impairment in cognitive and physical function. Interventions designed to prevent sarcopenia and improve muscle strength may help reduce the burden of cognitive and physical impairments of functionality in community-dwelling seniors.

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Related in: MedlinePlus

Distribution of impairment by sarcopenia status.Notes: Controls have lowest level of dual impairment, followed by pre-sarcopenic and finally, sarcopenic participants. Differences are significant at P<0.001.
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f1-cia-10-663: Distribution of impairment by sarcopenia status.Notes: Controls have lowest level of dual impairment, followed by pre-sarcopenic and finally, sarcopenic participants. Differences are significant at P<0.001.

Mentions: The proportion of participants in each of the three outcome groups by sarcopenia category is presented in Figure 1. While nearly one in three of those without evidence of sarcopenia had neither CI (based on MoCA) nor PI, only one in 12 sarcopenic participants had no impairment. Similarly, 20% of controls had combined CI/PI while the proportion was three times higher in those with sarcopenia. Pre-sarcopenic participants fell between controls and sarcopenic participants. This stepwise association is further evidenced in Table 2, in which the odds of being dually impaired vs singly impaired or non-impaired were 10%–50% higher in the pre-sarcopenia group (depending on the cognitive measure used) but 250% higher in the sarcopenia group in the fully adjusted model. Statistical significance was achieved for sarcopenia but not for pre-sarcopenia (P=0.415 for MoCA; P=0.867 for AD8). Akaike Information Criterion scores indicate the fully adjusted model as best fitting the data.30 Our sensitivity analysis indicates that inclusion of low muscle strength only in the non-sarcopenia group did not impact our result. The effect of pre-sarcopenia and sarcopenia on the likelihood of combined CI/PI remained unchanged (odds ratio [OR] =1.353, P=0.590 OR =1.568, P=0.406 for pre-sarcopenia vs non-sarcopenia using AD8 and MOCA, respectively; OR =4.658, P=0.013 and OR =3.574, P=0.037 for sarcopenia vs non-sarcopenia using AD8 and MOCA, respectively).


Sarcopenia and impairment in cognitive and physical performance.

Tolea MI, Galvin JE - Clin Interv Aging (2015)

Distribution of impairment by sarcopenia status.Notes: Controls have lowest level of dual impairment, followed by pre-sarcopenic and finally, sarcopenic participants. Differences are significant at P<0.001.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4388078&req=5

f1-cia-10-663: Distribution of impairment by sarcopenia status.Notes: Controls have lowest level of dual impairment, followed by pre-sarcopenic and finally, sarcopenic participants. Differences are significant at P<0.001.
Mentions: The proportion of participants in each of the three outcome groups by sarcopenia category is presented in Figure 1. While nearly one in three of those without evidence of sarcopenia had neither CI (based on MoCA) nor PI, only one in 12 sarcopenic participants had no impairment. Similarly, 20% of controls had combined CI/PI while the proportion was three times higher in those with sarcopenia. Pre-sarcopenic participants fell between controls and sarcopenic participants. This stepwise association is further evidenced in Table 2, in which the odds of being dually impaired vs singly impaired or non-impaired were 10%–50% higher in the pre-sarcopenia group (depending on the cognitive measure used) but 250% higher in the sarcopenia group in the fully adjusted model. Statistical significance was achieved for sarcopenia but not for pre-sarcopenia (P=0.415 for MoCA; P=0.867 for AD8). Akaike Information Criterion scores indicate the fully adjusted model as best fitting the data.30 Our sensitivity analysis indicates that inclusion of low muscle strength only in the non-sarcopenia group did not impact our result. The effect of pre-sarcopenia and sarcopenia on the likelihood of combined CI/PI remained unchanged (odds ratio [OR] =1.353, P=0.590 OR =1.568, P=0.406 for pre-sarcopenia vs non-sarcopenia using AD8 and MOCA, respectively; OR =4.658, P=0.013 and OR =3.574, P=0.037 for sarcopenia vs non-sarcopenia using AD8 and MOCA, respectively).

Bottom Line: Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female) were recruited and underwent physical functionality, anthropometry, and cognitive testing.Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2), physical impairment (Mini Physical Performance Test <12), both, or neither by ordinal logistic regression.The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass.

View Article: PubMed Central - PubMed

Affiliation: Alzheimer's Disease Center, Department of Neurology, New York University School of Medicine, New York, NY, USA.

ABSTRACT

Background: Whether older adults with sarcopenia who underperform controls on tests of physical performance and cognition also have a higher likelihood of combined cognitive-physical impairment is not clear. We assessed the impact of sarcopenia on impairment in both aspects of functionality and the relative contribution of its components, muscle mass and strength.

Methods: Two hundred and twenty-three community-dwelling adults aged 40 years and older (mean age =68.1±10.6 years; 65% female) were recruited and underwent physical functionality, anthropometry, and cognitive testing. Participants with low muscle mass were categorized as pre-sarcopenic; those with low muscle mass and muscle strength as sarcopenic; those with higher muscle mass and low muscle strength only were categorized as non-sarcopenic and were compared on risk of cognitive impairment (Montreal Cognitive Assessment <26; Ascertaining Dementia 8 ≥2), physical impairment (Mini Physical Performance Test <12), both, or neither by ordinal logistic regression.

Results: Compared to controls, those with sarcopenia were six times more likely to have combined cognitive impairment/physical impairment with a fully adjusted model showing a three-fold increased odds ratio. The results were consistent across different measures of global cognition (odds ratio =3.46, 95% confidence interval =1.07-11.45 for the Montreal Cognitive Assessment; odds ratio =3.61, 95% confidence interval =1.11-11.72 for Ascertaining Dementia 8). Pre-sarcopenic participants were not different from controls. The effect of sarcopenia on cognition is related to low muscle strength rather than low muscle mass.

Conclusion: Individuals with sarcopenia are not only more likely to have single but also to have dual impairment in cognitive and physical function. Interventions designed to prevent sarcopenia and improve muscle strength may help reduce the burden of cognitive and physical impairments of functionality in community-dwelling seniors.

Show MeSH
Related in: MedlinePlus