Abstract
Objectives
The prevalence of obesity with sarcopenia is increasing in adults aged ≥65 years.
This geriatric syndrome places individuals at risk for synergistic complications that
leads to long-term functional decline. We ascertained the relationship between sarcopenic
obesity and incident long-term impaired global cognitive function in a representative
US population.
Design
A longitudinal, secondary data set analysis using the National Health and Aging Trends
Survey.
Setting
Community-based older adults in the United States.
Participants
Participants without baseline impaired cognitive function aged ≥65 years with grip
strength and body mass index measures.
Methods
Sarcopenia was defined using the Foundation for the National Institutes of Health
Sarcopenia Project grip strength cut points (men <35.5 kg; women <20 kg), and obesity
was defined using standard body mass index (BMI) categories. Impaired global cognition
was identified as impairment in the Alzheimer's Disease-8 score or immediate/delayed
recall, orientation, clock-draw test, date/person recall. Proportional hazard models
ascertained the risk of impaired cognitive function over 8 years (referent = neither
obesity or sarcopenia).
Results
Of the 5822 participants (55.7% women), median age category was 75 to 80, and mean
grip strength and BMI were 26.4 kg and 27.5 kg/m2, respectively. Baseline prevalence of sarcopenic obesity was 12.9%, with an observed
subset of 21.2% participants having impaired cognitive function at follow-up. Compared
with those without sarcopenia or obesity, the risk of impaired cognitive function
was no different in obesity alone [hazard ratio (HR) 0.98; 95% confidence interval
(CI) 0.82–1.16]), but was significantly higher in sarcopenia (HR 1.60; 95% CI 1.42–1.80)
and sarcopenic obesity (HR 1.20; 95% CI 1.03–1.40). There was no significant interaction
term between sarcopenia and obesity.
Conclusions
Both sarcopenia and sarcopenic obesity are associated with an increased long-term
risk of impaired cognitive function in older adults.
Keywords
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Article info
Publication history
Published online: October 21, 2020
Footnotes
This work was conducted in part while John A. Batsis was at Dartmouth-Hitchcock Medical Center, Lebanon, NH.
The authors declare no conflicts of interest.
Dr. Batsis' research reported in this publication was supported in part by the National Institute on Aging of the National Institutes of Health (NIH) under Award Number K23AG051681. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH.
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
