PDF herunterladen
CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(05): 376-383
DOI: 10.1590/0004-282X-ANP-2020-0186
Article

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
Gabriela Cabett Cipolli 
1   Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brazil.
,
Ivan Aprahamian 
2   Faculdade de Medicina de Jundiaí, Departamento de Clínica Médica, Grupo de Investigação sobre Multimorbidade e Saúde Mental no Envelhecimento, Jundiaí SP, Brazil.
,
Flávia Silva Arbex Borim 
3   Universidade Estadual de Campinas, Programa de Pós-Graduação em Gerontologia, Campinas SP, Brazil.
4   Universidade de Brasília, Faculdade de Ciências de Saúde, Departamento de Saúde Coletiva, Brasília DF, Brazil.
,
Deusivania Vieira Silva Falcão 
1   Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brazil.
,
Meire Cachioni 
1   Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brazil.
3   Universidade Estadual de Campinas, Programa de Pós-Graduação em Gerontologia, Campinas SP, Brazil.
,
Ruth Calderia de Melo 
1   Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brazil.
,
Samila Sathler Tavares Batistoni 
1   Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brazil.
3   Universidade Estadual de Campinas, Programa de Pós-Graduação em Gerontologia, Campinas SP, Brazil.
,
Anita Liberaleso Neri 
3   Universidade Estadual de Campinas, Programa de Pós-Graduação em Gerontologia, Campinas SP, Brazil.
,
Mônica Sanches Yassuda 
1   Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brazil.
3   Universidade Estadual de Campinas, Programa de Pós-Graduação em Gerontologia, Campinas SP, Brazil.
› InstitutsangabenAll authors declare that they received support for this research from the São Paulo Research Foundation (FAPESP) [2016/00084-8].
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

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.

RESUMO

Introdução: A ligação entre sarcopenia e comprometimento cognitivo ainda não foi completamente avaliada, especialmente entre os idosos. Objetivo: Avaliar a relação entre sarcopenia provável e comprometimento cognitivo entre idosos residentes na comunidade em duas cidades brasileiras. Métodos: A sarcopenia provável foi avaliada pelo critério EWGSOP2 (2018), portanto, os participantes foram classificados como tendo sarcopenia provável se tivessem SARC-F (em inglês, Strength, Assistance in walking, Rise from a chair, Climb stairs and Falls) ≥4 pontos e baixa força de preensão manual. A função cognitiva foi avaliada através do Miniexame do Estado Mental (MEEM), fluência verbal (FV) e teste do desenho do relógio (TDR). Resultados: Em uma amostra de 529 idosos (idade média 80,8±4,9 anos; escolaridade média 4,2 (±3,67) anos; 70,1% de mulheres), 27,3% dos participantes apresentaram SARC-F≥4, 38,3% apresentaram baixa força de preensão manual e 13,6% foram classificados com sarcopenia provável. Após o ajuste para possíveis fatores de confusão (idade, sexo, educação, depressão, diabetes, hipertensão, atividade física no lazer e obesidade), a sarcopenia provável foi associada ao comprometimento no MEEM (OR 2,52; IC95% 1,42‒4,47; p=0,002) e na FV (OR 2,17; IC95%=1,17‒4,01; p=0,014); a baixa força de preensão foi associada a comprometimento no MEEM (OR 1,83; IC95% 1,18‒2,82; p=0,006) e no TDR (OR 1,79; IC95% 1,18‒2,73; p=0,006); e os escores na SARC-F foram associados ao comprometimento no MEEM (OR 1,90; IC95% 1,18‒3,06; p=0,008). Conclusão: Os resultados sugerem que existe associação significativa entre sarcopenia provável e seus componentes com déficits cognitivos em idosos da comunidade. Futuros estudos longitudinais explorarão a relação causal.

Keywords:

Cognitive Impairment - Cognition - Aged - Sarcopenia - Hand Strength

Palavras-chave:

Comprometimento Cognitivo - Cognição - Idosos - Sarcopenia - Força da Mão

Authors’ contributions:

GCC, IA and MSY: contributed to the conception and design of the present study. FSAB: organized and analyzed the data. GCC: performed the literature review and organized the tables. GCC: wrote the manuscript and all authors contributed to reviewing the manuscript and they read and approved the submitted version.


Support:

All authors declare that they received support for this research from the São Paulo Research Foundation (FAPESP) [2016/00084-8].




Publikationsverlauf

Eingereicht: 05. Mai 2020

Angenommen: 21. Juli 2020

Artikel online veröffentlicht:
07. Juni 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • REFERENCES

  • 1 Morley JE, Abbatecola AM, Argiles JM, Baracos V, Bauer J, Bhasin S, et al. Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc. 2011 Jul;12(6):403-9. https://doi.org/10.1016/j.jamda.2011.04.014
  • 2 Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing. 2010 Jul;39(4):412-23. https://doi.org/10.1093/ageing/afq034
  • 3 Dent E, Morley JE, Arai H, Kritchevsky SB, Guralnik J, Bauer JM, et al. International Clinical Practice Guidelines for Sarcopenia (Icfsr): screening, diagnosis and management. J Nutr Health Aging. 2018;22(10):1148-61. https://doi.org/10.1007/s12603-018-1139-9
  • 4 Janssen I, Shepard ÃDS, Katzmarzyk PT, Roubenoff R, Mhs Ã. The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc. 2004 Jan;52(1):80-5. https://doi.org/10.1111/j.1532-5415.2004.52014.x
  • 5 Cawthon PM, Travison TG, Manini TM, Patel S, Pencina KM, Fielding RA, et al. Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes: proceedings of the sarcopenia definition and outcomes consortium conference. J Gerontol A Biol Sci Med Sci. 2020 Jun;75(7):1317-23. https://doi.org/10.1093/gerona/glz081
  • 6 Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan;48(1):16-31. https://doi.org/10.1093/ageing/afy169
  • 7 Tolea IM, Galvin EJ. Sarcopenia and impairment in cognitive and physical performance. Clin Interv Aging. 2015 Oct;10:663-71. https://doi.org/10.2147/CIA.S76275
  • 8 Hsu YH, Liang CK, Chou MY, Liao MC, Lin YT, Chen LK, et al. Association of cognitive impairment, depressive symptoms and sarcopenia among healthy older men in the veterans retirement community in southern Taiwan: A cross-sectional study. Geriatr Gerontol Int. 2014 Feb;14 Suppl 1:102-8. https://doi.org/10.1111/ggi.12221
  • 9 Lopez OL, Kuller LH. Epidemiology of aging and associated cognitive disorders: prevalence and incidence of Alzheimer's disease and other dementias. Handb Clin Neurol. 2019;167:139-48. https://doi.org/10.1016/B978-0-12-804766-8.00009-1
  • 10 Alzheimer's Disease International. 2019. World Alzheimer Report 2019: Attitudes to dementia. London: Alzheimer's Disease International.
  • 11 Alexandre TS, Duarte YAO, Santos JLF, Wong R, Lebrão ML. Prevalence and associated factors of sarcopenia among elderly in Brazil: findings from the SABE study. J Nutr Health Aging. 2014 Mar;18(3):284-90. https://doi.org/10.1007/s12603-013-0413-0
  • 12 Gao L, Jiang J, Yang M, Hao Q, Luo L, Dong B. Prevalence of sarcopenia and associated factors in Chinese community-dwelling elderly: comparison between rural and urban areas. J Am Med Dir Assoc. 2015 Nov;16(11):1003.e1-6. https://doi.org/10.1016/j.jamda.2015.07.020
  • 13 Huang CY, Hwang AC, Liu LK, Lee WJ, Chen LY, Peng LN, et al. Association of dynapenia, sarcopenia, and cognitive impairment among community-dwelling older taiwanese. Rejuvenation Res. 2016 Feb;19(1):71-8. https://doi.org/10.1089/rej.2015.1710
  • 14 Ogawa Y, Kaneko Y, Sato T, Shimizu S, Kanetaka H, Hanyu H. Sarcopenia and muscle functions at various stages of Alzheimer disease. Front Neurol. 2018 Aug;9:710. https://doi.org/10.3389/fneur.2018.00710
  • 15 Papachristou E, Ramsay SE, Lennon LT, Papacosta O, Iliffe S, Whincup PH, et al. The relationships between body composition characteristics and cognitive functioning in a population-based sample of older British men. BMC Geriatr. 2015 Dec;15:172. https://doi.org/10.1186/s12877-015-0169-y
  • 16 Sugimoto T, Ono R, Murata S, Saji N, Matsui Y, Niida S, et al. Prevalence and associated factors of sarcopenia in elderly subjects with amnestic mild cognitive impairment or Alzheimer disease. Curr Alzheimer Res. 2016;13(6):718-26. https://doi.org/10.2174/1567205013666160211124828
  • 17 Nishiguchi S, Yamada M, Shirooka H, Nozaki Y, Fukutani N, Tashiro Y, et al. Sarcopenia as a risk factor for cognitive deterioration in community-dwelling older adults: a 1-year prospective study. J Am Med Dir Assoc. 2016 Apr;17(4):372.e5-8. https://doi.org/10.1016/j.jamda.2015.12.096
  • 18 Nishiguchi S, Yamada M, Fukutani N, Adachi D, Tashiro Y, Hotta T, et al. Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults. J Am Med Dir Assoc. 2015 Feb;16(2):120-4. https://doi.org/10.1016/j.jamda.2014.07.010
  • 19 Samper-Ternent R, Reyes-Ortiz C, Ottenbacher KJ, Cano CA. Frailty and sarcopenia in Bogotá: results from the SABE Bogotá Study. Aging Clin Exp Res. 2017 Apr;29(2):265-72. https://doi.org/10.1007/s40520-016-0561-2
  • 20 van Kan GA, Cesari M, Gillette-Guyonnet S, Dupuy C, Nourhashémi F, Schott AM, et al. Sarcopenia and cognitive impairment in elderly women: Results from the EPIDOS cohort. Age Ageing. 2013 Mar;42(2):196-202. https://doi.org/10.1093/ageing/afs173
  • 21 Szlejf C, Suemoto CK, Lotufo PA, Benseñor IM. Association of sarcopenia with performance on multiple cognitive domains: results from the ELSA-Brasil Study. J Gerontol A Biol Sci Med Sci. 2019 Oct;74(11):1805-11. https://doi.org/10.1093/gerona/glz118
  • 22 Neri AL, Yassuda MS, de Araújo LF, Eulálio MC, Cabral BE, de Siqueira MEC, et al. Metodologia e perfil sociodemográfico, cognitivo e de fragilidade de idosos comunitários de sete cidades brasileiras: Estudo FIBRA. Cad Saúde Pública. 2013 Apr;29(4):778-92. https://doi.org/10.1590/S0102-311X2013000400015
  • 23 Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arq Neuro-Psiquiatr. 2003 Sep;61(B):209. https://doi.org/10.1590/S0004-282X2003000500014
  • 24 Barbosa-Silva TG, Menezes AMB, Bielemann RM, Malmstrom TK, Gonzalez MC. Enhancing SARC-F: Improving Sarcopenia Screening in the Clinical Practice. J Am Med Dir Assoc. 2016 Dec;17(12):1136-41. https://doi.org/10.1016/j.jamda.2016.08.004
  • 25 Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013 Aug;14(8):531-2. https://doi.org/10.1016/j.jamda.2013.05.018
  • 26 Dodds R, Sayer AA. Sarcopenia. Arq Bras Endocrinol Metabol. 2014 Jul;58(5):464-9. https://doi.org/10.1590/0004-27320200186
  • 27 Caramelli P, Carthery-Goulart MT, Porto CS, Charchat-Fichman H, Nitrini R. Category fluency as a screening test for Alzheimer disease in illiterate and literate patients. Alzheimer Dis Assoc Disord. 2007 Jan-Mar;21(1):65-7. https://doi.org/10.1097/WAD.0b013e31802f244f
  • 28 Shulman KI, Pushkar Gold D, Cohen CA, Zucchero CA. Clock‐drawing and dementia in the community: a longitudinal study. Int J Geriatr Psychiatry. 1993 Jun;8(6):487-96. https://doi.org/10.1002/gps.930080606
  • 29 Aprahamian I, Martinelli JE, Yassuda MS. Doença de Alzheimer em idosos com baixa escolaridade: o teste do Desenho do Relógio pode ser útil no rastreio cognitivo? Rev Soc Bras Clín Méd. 2008;6(4):130-4.
  • 30 Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498-504. https://doi.org/10.1097/00005768-200009001-00009
  • 31 Lustosa LP, Silva JP, Coelho FM, Pereira DS, Parentoni AN, Pereira LSM. Efeito de um programa de resistência muscular na capacidade funcional e na força muscular dos extensores do joelho em idosas pré-frágeis da comunidade: Ensaio clínico aleatorizado do tipo crossover. Rev Bras Fisioter. 2011 Aug-Sep;15(4):318-24. https://doi.org/10.1590/S1413-35552011000400010
  • 32 Taylor HL, Jacobs DR, Schucker B, Knudsen J, Leon AS, Debacker G. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis. 1978;31(12):741-55. https://doi.org/10.1016/0021-9681(78)90058-9
  • 33 Cipolli GC, Yassuda MS, Aprahamian I. Sarcopenia is associated with cognitive impairment in older adults: a systematic review and meta-analysis. J Nutr Health Aging. 2019;23(6):525-31. https://doi.org/10.1007/s12603-019-1188-8
  • 34 Shaughnessy KA, Hackney KJ, Clark BC, Kraemer WJ, Terbizan DJ, Bailey RR, et al. A narrative review of handgrip strength and cognitive functioning: bringing a new characteristic to muscle memory. J Alzheimers Dis. 2020;73(4):1265-78. https://doi.org/10.3233/JAD-190856
  • 35 Alfaro-Acha A, Snih SA, Raji MA, Markides KS, Ottenbacher J. Does 8-foot walk time predict cognitive decline in older Mexicans Americans?. J Am Geriatr Soc. 2007 Feb;55(2):245-51. https://doi.org/10.1111/j.1532-5415.2007.01039.x.
  • 36 van Dam PS, Aleman A, de Vries WR, Deijen JB, van der Veen EA, de Haan EHF, et al. Growth hormone, insulin-like growth factor I and cognitive function in adults. Growth Horm IGF Res. 2000 Apr;10 Suppl B:S69-73. https://doi.org/10.1016/s1096-6374(00)80013-1
  • 37 Meng SJ, Yu LJ. Oxidative stress, molecular inflammation and sarcopenia. Int J Mol Sci. 2010 Apr;11(4):1509-26. https://doi.org/10.3390/ijms11041509
  • 38 Wilson D, Jackson T, Sapey E, Lord JM. Frailty and sarcopenia: The potential role of an aged immune system. Ageing Res Rev. 2017 Jul;36:1-10. https://doi.org/10.1016/j.arr.2017.01.006
  • 39 Reijnierse EM, Trappenburg MC, Blauw GJ, Verlaan S, de van der Schueren MAE, Meskers CGM, et al. Common ground? The concordance of sarcopenia and frailty definitions. J Am Med Dir Assoc. 2016 Apr;17(4):371.e7-12. https://doi.org/10.1016/j.jamda.2016.01.013
  • 40 Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. https://doi.org/10.1093/gerona/56.3.m146