Sarcopenia and impairment in cognitive and physical performance

Figures & data

Table 1 Participant characteristics by level of impairment

Characteristic	Cognitive impairment (MoCA <26) and physical impairment				Cognitive impairment (AD8 ≥2) and physical impairment
	None	Either type	Both types	P-value	None	Either type	Both types	P-value
Age, yrs	62.9 (±9.7)	66.5 (±10.3)	74.3 (±7.6)	<0.001	62.8 (±9.8)	69.2 (±9.2)	75.4 (±9.4)	<0.001
Education, yrs	14.8 (±3.2)	14.2 (±3.9)	10.8 (±4.7)	<0.001	14.7 (±3.7)	13.2 (±4.4)	10.7 (±4.8)	<0.001
Female, %	62.7	55.9	81.8	0.005	55.9	64.4	85.0	0.006
White race, %	60.3	39.0	25.9	0.006	50.6	36.1	28.2	0.108
BMI, lb/in^2	27.6 (±6.2)	27.8 (±5.3)	29.2 (±5.3)	0.278	27.9 (±6.0)	28.2 (±5.5)	28.1 (±5.1)	0.939
Depression	4.6 (±3.6)	5.4 (±4.07)	5.9 (±4.21)	0.256	3.7 (±2.9)	6.1 (±3.9)	7.5 (±4.8)	<0.001
Muscle mass, lb	106.4 (±24.7)	105.8 (±22.9)	91.6 (±22.1)	<0.001	107.6 (±25.0)	102.3 (9±20.8)	89.4 (±22.8)	<0.001
Grip strength, lb	64.3 (±26.7)	58.7 (±24.9)	42.3 (±13.6)	<0.001	66.4 (±27.3)	51.1 (±19.9)	41.3 (±12.9)	<0.001
Walking time, sec	13.6 (±2.2)	14.8 (±3.9)	20.1 (±4.2)	<0.001	13.5 (±2.0)	16.4 (±4.7)	20.5 (±5.1)	<0.001
MoCA score, 0–30 points	27.8 (±1.3)	21.9 (±4.9)	19.4 (±4.2)	<0.001	24.5 (±4.5)	22.1 (±5.6)	21.2 (±4.6)	<0.001
AD8 score, 0–8 points	1.1 (±1.8)	1.8 (±1.9)	2.0 (±1.8)	0.012	0.3 (±0.5)	2.4 (±2.1)	3.4 (±1.2)	<0.001

Notes: Physical impairment = MPPT <12 points; depression was measured with HADS. All data are ± SD unless otherwise noted.

Abbreviations: yrs, years; lb, pounds; sec, seconds; in, inches; SD, standard deviation; BMI, Body Mass Index; MoCA, Montreal Cognitive Assessment; MPPT, Mini Physical Performance Test; HADS, Hospital Anxiety Depression scale; AD8, Ascertaining Dementia 8.

Table 2 Likelihood of having both cognitive and physical functional impairment (vs either type of impairment or none), according to level of sarcopenia

Level of sarcopenia	OR of having both cognitive impairment (based on MoCA) and physical impairment€			OR of having both cognitive impairment (based on AD8) and physical impairment
	Unadjusted	Adjusted 1	Adjusted 2	Unadjusted	Adjusted 1	Adjusted 2
Controls	1.0	1.0	1.0	1.0	1.0	1.0
Pre-sarcopenia	0.90 (0.426–1.940)	1.09 (0.415–3.853)	1.54 (0.544–4.370)	0.93 (0.432–1.986)	0.80 (0.302–2.137)	1.10 (0.375–3.207)
Sarcopenia	6.02 (2.577–14.331)	4.09 (1.405–11.907)	3.46 (1.072–11.452)	6.10 (2.729–14.068)	3.07 (1.098–8.607)	3.612 (1.113–11.725)
N	213	196	180	217	200	184
AIC	438.3	376.9	345.7	439.5	366.6	309.0

Notes: Adjusted 1, adjusted for age, sex, race, and BMI. Adjusted 2, adjusted 1+ depression.

€ Physical impairment based on total Mini PPT score (<12). The values in parentheses represent 95% confidence intervals.

Abbreviations: N, number of subjects; AIC, Akaike Information Criterion; OR, odds ratio; MoCA Montreal Cognitive Assessment; AD8, Ascertaining Dementia 8; vs, versus.

Table 3 Individual effect of muscle mass and muscle strength on cognitive and functional impairment

Predictor	OR of combined impairment (MoCA)€	OR of combined impairment (AD8)€
Low vs normal/high MM	2.290 (0.970–5.407)	1.946 (0.816–4.639)
Low vs normal/high grip strength	1.498 (0.708–3.172)	2.673 (1.213–5.627)

Notes:

€ Adjusted for age, sex, race, BMI, and depression. The values in parentheses represent 95% confidence intervals.

Abbreviations: BMI, body mass index; MoCA, Montreal Cognitive Assessment; MM, muscle mass; vs, versus; OR, odds ratio; AD8, Ascertaining Dementia 8.

Figure 1 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.