Probable sarcopenia is associated with cognitive impairment among community-dwelling older adults: results from the FIBRA study

Cipolli, Gabriela Cabett; Aprahamian, Ivan; Borim, Flávia Silva Arbex; Falcão, Deusivania Vieira Silva; Cachioni, Meire; Melo, Ruth Calderia de; Batistoni, Samila Sathler Tavares; Neri, Anita Liberaleso; Yassuda, Mônica Sanches

doi:10.1590/0004-282X-ANP-2020-0186

Acessibilidade / Reportar erro

Brasil

Arquivos de Neuro-Psiquiatria

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Article • Arq. Neuro-Psiquiatr. 79 (5) • May 2021 • https://doi.org/10.1590/0004-282X-ANP-2020-0186 copy

Probable sarcopenia is associated with cognitive impairment among community-dwelling older adults: results from the FIBRA study

Sarcopenia provável está associada com comprometimento cognitivo em idosos da comunidade: resultados do estudo FIBRA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background:

The link between sarcopenia and cognitive impairment has not yet been thoroughly evaluated, especially among older adults.

Objective:

To evaluate the relationship between probable sarcopenia and cognitive impairment among community-dwelling older adults in two Brazilian cities.

Methods:

Probable sarcopenia was assessed using the EWGSOP2 (2018) criteria. Thus, participants were classified as probably having sarcopenia if they had SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs and Falls) ≥4 points and low grip strength. Cognitive function was evaluated through the Mini-Mental State Examination (MMSE), verbal fluency (VF) and clock drawing test (CDT).

Results:

In a sample of 529 older adults (mean age 80.8±4.9 years; mean education 4.2±3.67 years; 70.1% women), 27.3% of the participants had SARC-F≥4, 38.3% had low grip strength and 13.6% were classified as probable sarcopenia cases. After adjusting for possible confounders (age, sex, education, depression, diabetes, hypertension, leisure-time physical activity and obesity), probable sarcopenia was found to be associated with impairment in the MMSE (OR 2.52; 95%CI 1.42‒4.47; p=0.002) and in VF (OR 2.17; 95%CI 1.17‒4.01; p=0.014). Low grip strength was found to be associated with impairment in the MMSE (OR 1.83; 95%CI 1.18‒2.82; p=0.006) and in the CDT (OR 1.79; 95%CI 1.18‒2.73; p=0.006). SARC-F scores were found to be associated with impairment in the MMSE (OR 1.90; 95%CI 1.18‒3.06; p=0.008).

Conclusion:

The results suggested that probable sarcopenia and its components present a significant association with cognitive deficits among community-dwelling older adults. Future longitudinal studies will further explore the causal relationship.

Keywords:
Cognitive Impairment; Cognition; Aged; Sarcopenia; Hand Strength

		Without probable sarcopenia n=457 (86.4%)	With probable sarcopenia n=72 (13.6%)	Total	p-value
Age, n (%)
	73‒79	206 (45.0%)	19 (26.4%)	225 (42.5%)	0.003^a a Pearson's chi-square test;
	˃80	251 (55%)	53 (73.6%)	304 (57.4%)	<0.001^b b Student's t-test.
	M (SD)	80.2 (4.6)	83.0 (5.3)	80.8 (4.9)
Sex, n (%) (women)		318 (85.5%)	54 (14.5%)	372 (70.1%)	0.337^a a Pearson's chi-square test;
Education, n (%)
	Illiterate	59 (13.5%)	11 (15.7%)	70 (13.8%)
	1–4 years	263 (60.3%)	45 (64.3%)	308 (60.8%)	0.437^a a Pearson's chi-square test;
	5–8 years	60 (13.8%)	10 (14.3%)	70 (13.8%)	0.047^b b Student's t-test.
	9 years or more	54 (12.4%)	4 (5.7%)	58 (11.4%)
	M (SD)	4.4 (3.8)	3.4 (2.9)	4.2 (3.6)
BMI, n (%)
	Eutrophic	196 (43.2%)	27 (38.0%)	223 (42.5%)
	Low weight	89 (19.6%)	17 (24.0%)	106 (20.2%)	0.617^a a Pearson's chi-square test;
	Overweight/obesity	169 (37.2%)	27 (38.0%)	196 (37.3%)	0.713^b b Student's t-test.
	M (SD)	27.1 (4.9)	26.9 (6.1)	27.1 (5.1)
Hypertension, n (%)
	Yes	302 (68.1%)	54 (78.2%)	356 (69.5%)	0.090^a a Pearson's chi-square test;
	No	141 (31.9%)	15 (21.8%)	156 (30.5%)
Diabetes, n (%)
	Yes	125 (28.3%)	46 (66.7%)	148 (29.0%)	0.396^a a Pearson's chi-square test;
	No	316 (71.6%)	23 (33.3%)	362 (71.0%)
Depression, n (%)
	Yes	71 (16.1%)	9 (13.0%)	80 (15.7%)	0.512^a a Pearson's chi-square test;
	No	369 (83.9%)	60 (87.0%)	429 (84.3%)
Physical activity, n (%)
	Active	212 (46.5%)	19 (26.4%)	231 (43.8%)	<0.001^a a Pearson's chi-square test;
	Inactive	244 (53.5%)	53 (73.6%)	297 (56.2%)
SARC-F, n (%)
	0–3 points	385 (84.0%)	0 (0.0%)	385 (72.6%)	<0.001^a a Pearson's chi-square test;
	≥4 points	73 (16.0%)	72 (100%)	145 (27.4%)	<0.001^b b Student's t-test.
	M (SD)	1.9 (1.93)	5.9 (1.6)	2.4 (2.3)
Handgrip strength, n (%)
	Normal	332 (72.5%)	0 (0.0%)	332 (62.6%)	<0.001^a a Pearson's chi-square test;
	Low strength	126 (27.5%)	72 (100%)	198 (37.4%)	<0.001^b b Student's t-test.
	M (SD)	23.1 (10.7)	14.2 (4.4)	21.7 (10.5)
MMSE, n (%)
	Without deficit	359 (80.0 %)	44 (61.1%)	403 (77.3%)	<0.001^a a Pearson's chi-square test;
	With deficit	90 (20.0%)	28 (38.9%)	118 (22.6%)	<0.001^b b Student's t-test.
	M (SD)	23.7 (4.0)	21.2 (5.3)	23.1 (4.6)
Verbal fluency, n (%)
	Without deficit	201 (46.1%)	19 (27.1%)	220 (43.5%)	0.003^a a Pearson's chi-square test;
	With deficit	235 (53.9%)	51 (72.9%)	286 (56.5%)	0.005^b b Student's t-test.
	M (SD)	10.7 (4.3)	9.2 (4.2)	10.4 (4.3)
Clock drawing test, n (%)
	Without deficit	179 (39.1%)	18 (25.0%)	197 (37.2%)	0.021^a a Pearson's chi-square test;
	With deficit	278 (60.9%)	54 (75.0%)	332 (62.8%)	0.005^b b Student's t-test.
	M (SD)	2.4 (1.8)	1.9 (1.8)	2.4 (1.8)

		Overall cognition (MMSE)		Verbal fluency test (VF)		Clock drawing test (CDT)
		OR (95%CI)	P	OR (95%CI)	P	OR (95%CI)	P
Probable sarcopenia
	Crude analysis	2.53 (1.49‒4.30)	0.001	2.29 (1.31‒4.01)	0.004	0.21 (0.08‒0.50)	0.159
	Model 1^a a Model 1: logistic regression adjusted for age, sex and education;	2.57 (1.49‒4.42)	0.001	2.21 (1.24‒3.92)	0.007	2.02 (1.11‒3.66)	0.021
	Model 2^b b Model 2: logistic regression adjusted for age, sex, education, depression, diabetes, hypertension, leisure-time physical activity and obesity.	2.52 (1.42‒4.47)	0.002	2.17 (1.17‒4.01)	0.014	1.64 (0.90‒3.04)	0.111
SARC-F
	Crude analysis	1.83 (1.18‒2.83)	0.007	1.32 (0.88‒1.97)	0.167	1.28 (0.86‒1.92)	0.215
	Model 1^a a Model 1: logistic regression adjusted for age, sex and education;	1.88 (1.20‒2.85)	0.005	1.37 (0.90‒2.06)	0.134	1.20 (0.78‒1.83)	0.399
	Model 2^b b Model 2: logistic regression adjusted for age, sex, education, depression, diabetes, hypertension, leisure-time physical activity and obesity.	1.90 (1.18‒3.06)	0.008	1.22 (0.78‒1.90)	0.370	0.97 (0.62‒1.53)	0.929
Low handgrip strength
	Crude analysis	1.89 (1.27‒2.81)	0.002	1.51 (1.05‒2.16)	0.025	1.79 (1.23‒2.60)	0.002
	Model 1^a a Model 1: logistic regression adjusted for age, sex and education;	1.95 (1.29‒2.95)	0.001	1.45 (0.99 ‒2.11)	0.052	1.89 (1.27‒2.82)	0.002
	Model 2^b b Model 2: logistic regression adjusted for age, sex, education, depression, diabetes, hypertension, leisure-time physical activity and obesity.	1.83 (1.18‒2.82)	0.006	1.48 (0. 99‒2.21)	0.052	1.79 (1.18‒2.73)	0.006

Academia Brasileira de Neurologia - ABNEURO R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices Torre Norte, 04101-000 São Paulo SP Brazil, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revista.arquivos@abneuro.org

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Mônica Sanches Yassuda; E-mail: yassuda@usp.br.