scholarly journals Sarcopenia is Associated Cognitive Impairment Mainly Due to Slow Gait Speed: Results from the Korean Frailty and Aging Cohort Study (KFACS)

Author(s):  
Miji Kim ◽  
Chang Won Won

Cognitive impairment and sarcopenia may share common risk factors and pathophysiological pathways. This study was performed to examine the association between impairments in specific cognitive domains and sarcopenia (and its defining components) in a large group of community-dwelling older adults. Cross-sectional analysis was performed on the baseline data of 3,014 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study (KFACS). The final analysis included 1,887 adults underwent dual-energy X-ray absorptiometry and cognitive function assessments. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson’s disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04–2.99) and slow gait speed (OR 2.58, 95% CI 1.34–4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05–3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed.

Author(s):  
Miji Kim ◽  
Chang Won Won

Sarcopenia and cognitive impairment may share common risk factors and pathophysiological pathways. We examined the association between impairments in specific cognitive domains and sarcopenia (and its defining components) in community-dwelling older adults. We analyzed 1887 patients who underwent cognitive function tests and dual-energy X-ray absorptiometry from the baseline data of adults aged 70–84 years obtained from the Korean Frailty and Aging Cohort Study. Those with disability in activities of daily living, dementia, severe cognitive impairment, Parkinson’s disease, musculoskeletal complaints, neurological disorders, or who were illiterate were excluded. Cognitive function was assessed using the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet, the Frontal Assessment Battery. For sarcopenia, we used the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of sarcopenia was 9.6% for men and 7.6% for women. Sarcopenia (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.04–2.99) and slow gait speed (OR 2.58, 95% CI 1.34–4.99) were associated with cognitive impairment in men. Only slow gait speed (OR 1.88, 95% CI 1.05–3.36) was associated with cognitive impairment in women. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed. Our results suggested that cognitive impairment domains, such as processing speed and executive function, are associated with sarcopenia-related slow gait speed.


2018 ◽  
Vol 7 (10) ◽  
pp. 332 ◽  
Author(s):  
Miji Kim ◽  
Min Jeong ◽  
Jinho Yoo ◽  
Da Song ◽  
Chang Won

The aim of this study was to examine calf circumference in relation to cognitive frailty in community-dwelling older adults. Cross-sectional analysis was performed on the first-year baseline data of 1559 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. The final analysis included 1221 adults who were non-dependent in terms of instrumental activities of daily living, who underwent frailty and cognitive function assessments. Physical frailty was defined using the Fried Frailty Index. Cognitive impairment was defined as a score 1.5 standard deviations below the age-, sex- and education-matched norms on any of four cognitive-function tests. The prevalence of cognitive frailty was 2.8% for men and 3.8% for women. After adjusting for potential confounders, in comparison to the “physically robust without cognitive impairment” group, the estimates of increased odds ratios (ORs) for low calf circumference (<32 cm) were much greater in the prefrail with cognitive impairment (OR 4.62, 95% confidence interval (CI): 2.02–10.61) and frail with cognitive impairment (OR 10.94, 95% CI: 2.87–41.68) groups in men but not in women. Low calf circumference was strongly related to cognitive frailty in men only, suggesting calf circumference can be used as an indicator of these outcomes.


Author(s):  
Tran Dai Tri Han ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Vo Nu Hong Duc ◽  
Thang Van Vo

This study examined the prevalence of cognitive impairment among older adults in central Vietnam and the roles of communication (with or without communication devices) in the association between cognitive impairment and hearing loss. This cross-sectional study was performed on 725 randomly selected community-dwelling older adults aged ≥60 years from Thua Thien Hue province, Vietnam. Participants attended a face-to-face survey. Sociodemographic characteristics, social interaction with or without communication devices, health status and cognitive function using the Mini-Mental State Examination were reported. Ordinal logistic regression analysis was performed to quantify the association between hearing loss and cognitive function by frequency of communication with and without devices. Mild and severe cognitive impairment had prevalence rates of 23.6% and 19.3%, respectively. Cognitive impairment was more prevalent among older adults with hearing-loss, vision loss and difficulties with instrumental activities of daily living (IADL). The association between hearing loss and cognitive impairment was not significant when older adults had frequent communication with others using devices. This study presented the relatively high prevalence of cognitive impairment in community-dwelling older adults in Vietnam. Frequent communication using devices attenuated the association between hearing loss and cognitive impairment.


2021 ◽  
pp. 1-8
Author(s):  
Xiao Liu ◽  
Ayiguli Abudukeremu ◽  
Yuan Jiang ◽  
Zhengyu Cao ◽  
Maoxiong Wu ◽  
...  

Background: Several kinds of motor dysfunction can predict future cognitive impairment in elderly individuals. However, the ability of the fine motor index (FINEA) and gross motor index (GROSSA) to predict the risk of cognitive impairment has not been assessed. Objective: We investigated the associations between FINEA/GROSSA and cognitive impairment. Methods: The data of 4,745 participants from The Irish Longitudinal Study on Ageing (TILDA) were analyzed. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). We first assessed the correlation between the FINEA GROSSA and MMSE in a cross-sectional study. Then, we further investigated the predictive role of the incidence of cognitive impairment in a prospective cohort study. Results: We found that both FINEA and GROSSA were negatively correlated with MMSE in both the unadjusted (FINEA: B = –1.00, 95%confidence intervals (CI): –1.17, –0.83, t = –11.53, p <  0.001; GROSSA: B = –0.85, 95%CI: –0.94, –0.76, t = –18.29, p <  0.001) and adjusted (FINEA: B = –0.63, 95%CI: –0.79, –0.47, t = –7.77, p <  0.001; GROSSA: B = –0.57, 95%CI: –0.66, –0.48, t = –12.61, p <  0.001) analyses in a cross-sectional study. In a prospective cohort study, both high FINEA and high GROSSA were associated with an increased incidence of cognitive function impairment (FINEA: adjusted odds ratios (OR) = 2.35, 95%CI: 1.05, 5.23, p = 0.036; GROSSA adjusted OR = 3.00, 95%CI: 1.49, 6.03, p = 0.002) after 2 years of follow-up. Conclusion: Higher FINEA and GROSSA scores were both associated with an increased incidence of cognitive impairment. FINEA or GROSSA might be a simple tool for identifying patients with cognitive impairment.


Author(s):  
Hayoung Shim ◽  
Miji Kim ◽  
Chang Won Won

Motoric cognitive risk (MCR) syndrome is originally defined as the presence of subjective cognitive complaints (SCCs) and slow gait (SG). MCR is well known to be useful for predicting adverse health outcomes, including falls and dementia. However, around four out of five older Korean adults reported SCCs, thereby, it may not be discriminative to define MCR in Korea. We adopted the three-item recall (3IR) test, instead of SCCs, to define MCR. This cross-sectional analysis included 2133 community-dwelling older adults aged 70–84 years, without dementia or any dependence in activities of daily living from the Korean Frailty and Aging Cohort Study. The newly attempted criteria of MCR using 3IR were met by 105 participants (4.9%). MCR using 3IR showed synergistic effects on fall-related outcomes, whereas the conventional definition of MCR using SCCs was not superior to SG only. MCR using 3IR was associated with falls (odds ratio [OR]: 1.92; 95% confidence interval (CI): 1.16–3.16), recurrent falls (OR: 2.19; 95% CI: 1.12–4.32), falls with injury (OR: 1.98; 95% CI: 1.22–3.22), falls with fracture (OR: 2.51; 95% CI: 1.09–5.79), fear of falling (OR: 3.00; 95% CI: 1.83–4.92), and low activities-specific balance confidence (OR: 3.13; 95% CI: 1.57–6.25). We found that MCR using 3IR could be useful in predicting fall-related outcomes in a cultural background reporting more SCCs, such as Korea.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ji Yoon Kong ◽  
Jin Sug Kim ◽  
Min Hye Kang ◽  
Hyeon Seok Hwang ◽  
Chang Won Won ◽  
...  

Abstract Background Cognitive decline is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly population. We conducted this study to clarify the relationship between renal dysfunction and decline of cognitive function in community-dwelling elderly population. Methods A cross-sectional analysis was performed using data from the Korean Frailty and Aging Cohort Study, a nationwide cohort study. Total 2847 (1333 men, 1514 women) eligible participants were enrolled for this study. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Global cognitive function was assessed with the Mini-mental State Examination-Korean version. Other domains of cognitive function were tested with the Consortium to Establish a Registry for Alzheimer’s disease and the Frontal Assessment Battery. Results The mean age of all participants was 76.0 ± 3.9 years and eGFR (all in mL/min/1.73 m2) was 77.5 ± 14.3. And the mean eGFR was 91.7 ± 3.2 in quartile 1, 84.9 ± 1.8 in quartile 2, 76.1 ± 3.7 in quartile 3, and 57.2 ± 10.8 in quartile 4. In baseline characteristics, participants with lower eGFR tend to have lower cognitive function scores than participant with higher eGFR. In linear regression analysis, eGFR was correlated with the word list memory (β = 0.53, P = 0.005), word list recall (β = 0.86, P < 0.001), and word list recognition (β = 0.43, P = 0.030) after adjustment of confounding variables. Moreover, after multivariate adjustment the association with cognitive impairment in quartile 2 was stronger (adjusted OR: 1.535, 95% CI: 1.111–2.120, P = 0.009), and the ORs of cognitive impairment were 1.501 (95% CI: 1.084–2.079, P = 0.014) in quartile 3 and 1.423 (95% CI: 1.022–1.983, P = 0.037) in quartile 4. Conclusion In older adults, the immediate, recent memory, and recognition domains were significantly related to renal function. Also, the mild renal dysfunction was independently associated with impairment of global cognitive function. These results suggest that the early stages of renal dysfunction could be an effective target to prevent worsening of cognitive impairment. Therefore, regular monitoring and early detection of mild renal dysfunction in elderly population might be needed.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Sonal Agrawal ◽  
Lei Yu ◽  
Sukriti Nag ◽  
Konstantinos Arfanakis ◽  
Lisa L. Barnes ◽  
...  

AbstractLewy bodies (LBs) and limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) are common in older persons and associated with cognitive impairment. However, little is known about the relationship between LBs and LATE-NC and their combined roles in cognitive impairment and Alzheimer’s dementia in community-dwelling participants. The study included 1670 community-based participants (mean age-at-death, 89.5 years (SD = 6.65); 69% females) who underwent annual assessments of cognition to create summary measures of global cognition and cognitive domains and evaluation for Alzheimer’s dementia. Systematic neuropathologic evaluations were performed to assess LBs, LATE-NC, and Alzheimer’s disease (AD) pathology. We excluded cases with pathologically confirmed frontotemporal lobar degeneration in this study. Logistic and linear regression analyses were used, adjusted for demographics and AD pathology. LBs were present in 428 (25.6%) decedents (29 nigra-predominant, 165 limbic-type, and 234 neocortical-type) while 865 (51.7%) decedents exhibited LATE-NC (307 stage 1, 167 stage 2, and 391 stage 3). LBs combined with LATE-NC were common (15% of all participants) and in those with Alzheimer’s dementia (25%). Neocortical-type, but not nigral-predominant or limbic-type LBs increased the odds of stage 2/3 LATE-NC (odds ratio = 1.70; 95% confidence interval = 1.26–2.30). The association between neocortical-type LBs and stage 2/3 LATE-NC was stronger in those under 90 years of age and in women. In analyses of cognition and Alzheimer’s dementia, LATE-NC and neocortical-type LBs, separately, were related to lower global cognition, five specific cognitive domains, and an increased odds of Alzheimer’s dementia, above and beyond the AD pathology. Limbic-type LBs were related to lower global cognition, and the domains of episodic, working, and semantic memory, and increased odds of Alzheimer’s dementia. Furthermore, there was no interaction between limbic/neocortical-type LBs and LATE-NC on cognitive function, cognitive domains, or Alzheimer’s dementia. These findings suggest that neocortical-type LBs are associated with LATE-NC, specifically in the younger old and in women. Limbic/neocortical-type LBs and LATE-NC have separate and additive effects on cognitive function and odds of Alzheimer’s dementia.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Andreea Rawlings ◽  
A. Richey Sharrett ◽  
Nisa Maruthur ◽  
Christina Parrinello ◽  
Casey Rebholz ◽  
...  

Introduction: The association between glucose excursions and cognitive function in older adults with diabetes is not well described. 1,5-anhydroglucitol (1,5-AG) is a novel biomarker of hyperglycemic excursions. Low 1,5-AG levels reflect blood glucose concentrations exceeding the renal filtration threshold (~180 mg/dl) over the prior 1-2 weeks. Our aim was to test the hypothesis that glucose excursions, as measured by 1,5-AG, were associated with lower cognitive function in older adults with diabetes. Methods: We conducted a cross-sectional analysis of 2000 participants with diabetes from ARIC visit 5 (2011-2013). Diabetes was defined based on self-reported physician diagnosis, diabetes medication use, or HbA1c ≥6.5%. Eleven neuropsychological tests were summarized using Z scores and were grouped into three cognitive domains representing memory, executive function, and language; a global measure of cognitive function was also calculated by averaging and standardizing scores from all tests. 1,5-AG was dichotomized at 10 μg/mL, with values <10 μg/mL reflecting glycemic excursions. Participants were categorized into one of four groups based on 1,5-AG categories and glycemic control (HbA1c <7% vs ≥7%). We used linear regression and adjusted for demographic and clinical characteristics. Results: The mean age of participants was 75 years, 57% were female, and 78% were white. For persons with HbA1c ≥7%, the adjusted differences in cognitive scores comparing 1,5-AG <10 to 1,5-AG ≥10 ug/mL were significantly lower in all domains except memory (Figure). For persons with HbA1c <7%, there were no significant differences in cognitive scores between 1,5-AG categories. Conclusions: Short-term glucose excursions are independently associated with lower cognitive scores in older adults with diabetes and with poor glycemic control (HbA1c ≥7%). Prospective studies are needed to determine if targeting hyperglycemic excursions can improve cognitive function in older adults with diabetes.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Laxmi Gautam ◽  
Sean Millar ◽  
Ivan J. Perry ◽  
Janas Harrington

AbstractBackground and ObjectivesCognitive impairment among the elderly is an important concern worldwide. Evidence suggests that certain lifestyle behaviours may have a protective effect against cognitive decline. In this study we examined the relationship between a 5-component protective lifestyle behaviour score and cognitive function to determine whether the number of protective lifestyle behaviours is related to cognitive decline.Materials and MethodsThis was a cross-sectional analysis of the Mitchelstown Cohort Rescreen study, a random sample of men and women aged 51–77 years recruited from a single primary care centre. Cognitive function was assessed using the Mini Mental State Exam (MMSE) and cognitive data were available for 1,022 participants. Cognitive impairment was classified as an upper 75th percentile reversed MMSE score value for the study sample. We defined 5 low-risk protective lifestyle behaviours as never smoking, moderate alcohol intake, moderate to vigorous physical activity, a high-quality diet score (upper 40%) and a body mass index between 18.5 to 24.9 kg/m2. Linear and logistic regression analyses were used to test associations between a protective factor score and the MMSE.ResultsThere was a linear relationship between the number of protective lifestyle behaviours and mean cognitive score values and a significant inverse association was observed between a protective lifestyle score and the MMSE cognitive score (β = -0.20, 95% CI: -0.30, -0.10). Logistic regression suggested a dose-response relationship, with odds ratios of having poorer cognitive functioning being noticeably increased in subjects with 0 or 1 PLBs (OR = 2.18, 95% CI: 1.06, 4.52) when compared to participants with 4 or 5 PLBs in multivariable analysis.ConclusionsThese data imply that a combination of healthy lifestyle behaviours protects against cognitive impairment. As all of the examined factors are modifiable, small behavioural changes may help in preventing cognitive decline in an elderly population.


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