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Booranasuksakul U, Macdonald IA, Stephan BCM, Siervo M. Body Composition, Sarcopenic Obesity, and Cognitive Function in Older Adults: Findings From the National Health and Nutrition Examination Survey (NHANES) 1999-2002 and 2011-2014. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:539-552. [PMID: 38564377 DOI: 10.1080/27697061.2024.2333310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Sarcopenic-obesity (SO) is characterized by the concomitant presence of low muscle mass and high adiposity. This study explores the association of body composition and SO phenotypes with cognitive function in older adults. METHODS Cross-sectional data in older adults (≥60 years) from NHANES 1999-2002 and 2011-2014 were used. In the 1999-2002 cohort, phenotypes were derived from body mass index (BMI) and dual-X-ray-absorptiometry, and cognition was assessed the by Digit-Symbol-Substitution-Test (DSST). In the 2011-2014 cohort, phenotypes were derived from BMI, waist-circumference (WC), and hand-grip-strength (HGS). Cognition was assessed using four tests: DSST, Animal Fluency, the Consortium-to-Establish-a-Registry-for-Alzheimer's-Disease-Delayed-Recall, and Word Learning. Mediation analysis was conducted to evaluate the contribution of inflammation (C-reactive-protein, CRP) and insulin resistance (Homeostatic-Model-Assessment-for-Insulin-Resistance, HOMA-IR) to the association between body composition and cognitive outcomes. RESULTS The SO phenotype had the lowest DSST mean scores (p < 0.05) and was associated with a significant risk of cognitive impairment [Odds Ratio (OR) = 1.9; 95%CI 1.0-3.7, p = 0.027] in the 1999-2002 cohort. A higher ratio of fat mass and fat free mass (FM/FFM) also showed a greater risk of cognitive impairment (OR = 2.0; 95%CI 1.3-3.1, p = 0.004). In the 2011-2014 cohort, the high WC-Low HGS group showed significantly lower scores on all four cognitive tests (p < 0.05) and a higher risk of cognitive impairment. CRP and HOMA-IR were significant partial mediators of the association between FM/FFM and DSST in the 1999-2002 cohort. CONCLUSIONS The SO phenotype was associated with a higher risk of cognitive impairment in older adults. Insulin resistance and inflammation may represent key mechanisms linking SO to the development of cognitive impairment.
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Affiliation(s)
- Uraiporn Booranasuksakul
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ian A Macdonald
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Blossom C M Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, Australia
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, Australia
- School of Population Health, Curtin University, Perth, Australia
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Zhang N, Qu X, Zhou H, Kang L. Mapping Knowledge Landscapes and Emerging Trends of Sarcopenic Obesity in Older Adults: A Bibliometric Analysis From 2004 to 2023. Cureus 2024; 16:e62300. [PMID: 38873392 PMCID: PMC11170931 DOI: 10.7759/cureus.62300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
Background The prevalence of obesity in combination with sarcopenia, the age-related loss of muscle mass and strength or physical function, is on the rise among adults aged 65 years and older. A significant portion of this demographic now falls under the classification of sarcopenic obesity, a high-risk geriatric syndrome predominantly seen in an aging population vulnerable to compounded complications from both sarcopenia and obesity. It is essential to promptly evaluate the impact of academic research in this field, taking into account factors such as geographical regions, authors, journals, and institutions. Furthermore, exploring current topics and identifying potential areas that could inspire future researchers to conduct additional studies is crucial for advancing overall health in this population. Methodology A search was conducted in the Web of Science Core Collection database to identify English language articles and reviews focusing on sarcopenic obesity in older adults, published between January 1, 2004, and December 31, 2023. Bibliometric analysis was performed using VOSviewer (v.1.6.18) and CiteSpace (v.6.1.R2). Results A total of 985 original English-language articles were collected, consisting of 783 articles and 202 reviews. The volume of research publications in this field has shown significant growth since 2012. The United States leads in contributions, with 239 articles (24.3% of the total) and the highest number of citations at 18,403, along with the highest total link strength. The University of Melbourne in Australia stands out with 25 published articles (2.5% of the total). University of Verona in Italy has the most citations at 9,405, and Monash University in Australia has the highest total link strength at 53. Among prolific authors, John A. Batsis from Duke University is the most productive with 24 articles (2.4% of the total). The journal "Nutrients" has the most articles on sarcopenic obesity in older adults, publishing 54 articles (5.5% of the total). Key topics in this area include sarcopenia, obesity, sarcopenic obesity, and elderly. Recent interventions focus on "nutrition" and "exercise" for sarcopenic obesity in older adults. Conclusions Research on sarcopenic obesity in older adults has seen significant growth on a global scale from 2004 to 2023, indicating a promising area for further study with potential benefits from current advancements. Although academic inquiries have shed light on various aspects of sarcopenic obesity in older adults, there remains a noticeable dearth of clinical research and evidence-based medicine on the effective management of this condition in elderly individuals. Future studies could focus on developing tailored interventions for older adults with sarcopenic obesity.
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Affiliation(s)
- Ning Zhang
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Xuan Qu
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Haokang Zhou
- Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
| | - Lin Kang
- Department of Geriatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, CHN
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Chen Z, Ho M, Chau PH. Gender-specific moderating role of abdominal obesity in the relationship between handgrip strength and cognitive impairment. Clin Nutr 2023; 42:2546-2553. [PMID: 37931374 DOI: 10.1016/j.clnu.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND & AIMS Both low handgrip strength (HGS) and abdominal obesity (AO) are associated with cognitive impairment. However, it remains unclear whether low HGS and AO interact to affect cognition, and whether the synergistic effect varies by gender. This study aimed to examine whether the association between low HGS and incident cognitive impairment was moderated by AO among Chinese older men and women. METHODS We used the data of participants (≥60 years) from four waves (2011-2018) of the China Health and Retirement Longitudinal Study. We defined low HGS as the maximal HGS of <28 kg in men and <18 kg in women, and AO as waist circumference of ≥90 cm for men and ≥80 cm for women. Cognitive impairment was defined as a global cognitive score in the lowest 10th percentile. For each gender, we used subdistribution hazards model to estimate subdistribution hazard ratios (SHRs) for the association of low HGS and AO with incident cognitive impairment, treating mortality as the competing event and controlling for other covariates. Multiplicative interaction was assessed through a cross-product interaction term of low HGS and AO in the model. Additive interaction between low HGS and AO was evaluated by calculating the relative excess risk due to interaction (RERI) and attributable proportion due to interaction (AP). RESULTS We included 3704 participants (Mean age: 66.9 ± 5.81; 54.9% male). During the 7-year follow-up, 1133 events of interest occurred (731 cognitive impairments and 402 deaths). Incidence rates of cognitive impairment and mortality were 4.1 (95% CI: 3.8 to 4.4) and 2.2 (95% CI: 2.0 to 2.5) per 100 person-years. There were positive multiplicative (SHR for the product term = 1.974, 95% CI: 1.114 to 3.500) and additive interactions (RERI = 1.056, 95% CI: 0.027 to 2.086, AP = 0.454, 95% CI: 0.158 to 0.750) of low HGS and AO on the risk of cognitive impairment among older men. Male participants with both low HGS and AO showed an increased risk of cognitive impairment (SHR = 2.325, 95% CI: 1.498 to 3.609) compared with those without either. There was no evidence of interaction among older women (SHR for the product term = 1.151, 95% CI: 0.725 to 1.825; RERI = 0.044, 95% CI: -0.524 to 0.613; AP = 0.039, 95% CI: -0.458 to 0.536). CONCLUSIONS Low HGS and AO may interact to synergistically increase the risk of cognitive impairment among Chinese older men. Screening the highest-risk subpopulation, who may benefit most from neurocognitive prevention strategies, may maximize potential public health gains.
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Affiliation(s)
- Zi Chen
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China.
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Huang XT, Lv X, Jiang H. The weight-adjusted-waist index and cognitive impairment among U.S. older adults: a population-based study. Front Endocrinol (Lausanne) 2023; 14:1276212. [PMID: 38027119 PMCID: PMC10663941 DOI: 10.3389/fendo.2023.1276212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/29/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Multiple research projects have provided evidence of the correlation between obesity and cognitive impairment. WWI, a novel metric for assessing obesity, has the potential to provide a more precise assessment of muscle and fat mass. This research aimed to investigate the association between WWI and cognitive functioning among elderly individuals residing in the United States. Methods This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014. Weighted multiple linear regression models, smoothed fitted curves, and generalized weighted models were employed to examine the associations between WWI and cognitive function in linear and nonlinear contexts. Results The study included a cohort of 2,764 adult volunteers aged 60 years and older, all with complete data. Upon controlling for all potential confounding variables, our analysis revealed statistically significant negative associations between WWI and the Digit Symbol Substitution Test (DSST) score. Specifically, for each 1-unit increase in WWI, there was a corresponding loss of 3.57 points in the DSST score [-3.57 (-4.31, -2.82)]. The negative correlations between WWI with CERAD total word recall [-0.63 (-0.85, -0.40)], CERAD delayed recall [-0.19 (-0.30, -0.07)], and AFT [-0.65 (-0.94, -0.37)] were significant only in partially adjusted models. Conclusion Higher WWI was associated with poorer cognitive function.
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Affiliation(s)
| | - Xiang Lv
- Department of Anesthesiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Jiang
- Department of Anesthesiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Weng XF, Liu SW, Li M, Zhang Y, Zhang YC, Liu CF, Zhu JT, Hu H. Relationship between sarcopenic obesity and cognitive function in patients with mild to moderate Alzheimer's disease. Psychogeriatrics 2023; 23:944-953. [PMID: 37652079 DOI: 10.1111/psyg.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/16/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Previous research has linked sarcopenic obesity (SO) to cognitive function; however, the relationship between cognitive performance and SO Alzheimer's disease (AD) patients remains unclear. This study aimed to investigate their relationship in AD patients. METHODS One hundred and twenty mild to moderate AD patients and 56 normal controls were recruited. According to sarcopenia or obesity status, AD patients were classified into subgroups: normal, obesity, sarcopenia, and SO. Body composition, demographics, and sarcopenia parameters were assessed. Cognitive performance was evaluated using neuropsychological scales. RESULTS Among the 176 participants, the prevalence of SO in the moderate AD group was higher than in the normal control group. The moderate AD group had the lowest appendicular skeletal muscle mass index (ASMI) and the highest percentage of body fat (PBF). Hypertension and diabetes were more prevalent in the SO group than in the normal group among the subgroups. The sarcopenia and SO groups exhibited worse global cognitive function compared to the normal and obesity groups. Partial correlation analysis revealed that ASMI, PBF, and visceral fat area were associated with multiple cognitive domains scores. In logistic regression analysis, after adjusting for confounders, obesity was not found to be associated with AD. However, sarcopenia (odds ratio (OR) = 5.35, 95% CI: 1.27-22.46) and SO (OR = 5.84, 95% CI: 1.26-27.11) were identified as independent risk factors for AD. CONCLUSIONS SO was associated with cognitive dysfunction in AD patients. Moreover, the impact of SO on cognitive decline was greater than that of sarcopenia. Early identification and intervention for SO may have a positive effect on the occurrence and progression of AD.
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Affiliation(s)
- Xiao-Fen Weng
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Geriatric Medicine, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Shan-Wen Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng Li
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Zhang
- School of Life Sciences and Technology, Changchun University of Science and Technology, Changchun, China
| | - Ying-Chun Zhang
- Department of Ultrasonography, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun-Feng Liu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiang-Tao Zhu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hua Hu
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Zhou C, Zhan L, He P, Yuan J, Zha Y. Associations of sarcopenic obesity vs either sarcopenia or obesity alone with cognitive impairment risk in patients requiring maintenance hemodialysis. Nutr Clin Pract 2023; 38:1115-1123. [PMID: 37525570 DOI: 10.1002/ncp.11044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The association between sarcopenic obesity (SO) and cognitive impairment (CI) risk in patients requiring maintenance hemodialysis (MHD) is not known. In this study, we investigated the prevalence of SO in MHD patients. Furthermore, we would explore and compare the associations between SO, sarcopenia, and obesity with CI risk in this population. METHODS A multicenter, cross-sectional study was conducted. Data from 2743 adult MHD patients were recorded. SO was defined as the co-occurrence of sarcopenia and obesity. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Multiple logistic regression models, stratified analyses, and interactive analyses were conducted. RESULTS 21.58% of the participants met the criteria for SO. The overall prevalence of CI was 23.3% in our study. Participants in the SO group had the highest CI prevalence (34.6%). The association between SO and CI was weakened but remained statistically significant after adjusting for age, sex, and educational status (odds ratio, 1.47; 95% CI, 1.11-1.96). However, associations between sarcopenia, obesity, and CI disappeared after adjusting for these variables. The additional adjustment did not attenuate the significant association between SO and CI. Subgroup analyses and interactive analyses showed that the associations were similar across subgroups (P > 0.05 for interaction for all). CONCLUSIONS SO and CI are highly prevalent in MHD patients. Participants with SO are at significantly higher risk of CI than those with sarcopenia or obesity alone. Furthermore, this association is consistent across different subgroups.
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Affiliation(s)
- Chaomin Zhou
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
- Medical College of Guizhou University, Guiyang, China
| | - Lin Zhan
- Central Laboratory of Guizhou Provincial People's Hospital, Guiyang, China
| | - PignHong He
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
| | - Jing Yuan
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
| | - Yan Zha
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
- Medical College of Guizhou University, Guiyang, China
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Rosano C, Newman A, Santanasto A, Zhu X, Goodpaster B, Miljkovic I. Increase in skeletal muscular adiposity and cognitive decline in a biracial cohort of older men and women. J Am Geriatr Soc 2023; 71:2759-2768. [PMID: 37282843 PMCID: PMC10524226 DOI: 10.1111/jgs.18419] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 04/03/2023] [Accepted: 04/08/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Obesity and loss of muscle mass are emerging as risk factors for dementia, but the role of adiposity infiltrating skeletal muscles is less clear. Skeletal muscle adiposity increases with older age and especially among Black women, a segment of the US population who is also at higher risk for dementia. METHODS In 1634 adults (69-79 years, 48% women, 35% Black), we obtained thigh intermuscular adipose tissue (IMAT) via computerized tomography at Years 1 and 6, and mini-mental state exam (3MS) at Years 1, 3, 5, 8 and 10. Linear mixed effects models tested the hypothesis that increased IMAT (Year 1-6) would be associated with 3MS decline (Year 5-10). Models were adjusted for traditional dementia risk factors at Year 1 (3MS, education, APOe4 allele, diabetes, hypertension, and physical activity), with interactions between IMAT change by race or sex. To assess the influence of other muscle and adiposity characteristics, models accounted for change in muscle strength, muscle area, body weight, abdominal subcutaneous and visceral adiposity, and total body fat mass (all measured in Years 1 and 6). Models were also adjusted for cytokines related to adiposity: leptin, adiponectin, and interleukin-6. RESULTS Thigh IMAT increased by 4.85 cm2 (Year 1-6) and 3MS declined by 3.20 points (Year 6-10). The association of IMAT increase with 3MS decline was statistically significant: an IMAT increase of 4.85 cm2 corresponded to a 3MS decline of an additional 3.60 points (p < 0.0001), indicating a clinically important change. Interactions by race and sex were not significant. CONCLUSIONS Clinicians should be aware that regional adiposity accumulating in the skeletal muscle may be an important, novel risk factor for cognitive decline in Black and White participants independent of changes to muscle strength, body composition and traditional dementia risk factors.
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Affiliation(s)
- Caterina Rosano
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Anne Newman
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Adam Santanasto
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Xiaonan Zhu
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | | | - Iva Miljkovic
- Department of Epidemiology, School of Public Health, University of Pittsburgh
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Du H, Yu M, Xue H, Lu X, Chang Y, Li Z. Association between sarcopenia and cognitive function in older Chinese adults: Evidence from the China health and retirement longitudinal study. Front Public Health 2023; 10:1078304. [PMID: 36703834 PMCID: PMC9871477 DOI: 10.3389/fpubh.2022.1078304] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Background Sarcopenia and cognitive impairment are the most common causes of disability in the aging population. The potential role of sarcopenia in the development of cognitive impairment remains poorly understood. A cross-sectional analysis was performed using nationally representative data to evaluate associations between sarcopenia and cognition in China. Methods We included 2,391 participants (35.63% female) who were at least 60 years of age in 2015 from the China Health and Retirement Longitudinal Study (CHARLS). Muscle strength, appendicular skeletal mass (ASM), and physical performance measurements, were measured to diagnose sarcopenia according to the Asian Working Group for Sarcopenia 2019 (AWGS2019). Cognitive function was assessed by 10 items in the Telephone Interview for Cognitive Status (TICS-10), delayed word recall, and graph drawing. Based on cognitive score tertiles, data were divided into three groups. Multiple linear and logistic regression models were used to assess the relationship between sarcopenia and cognition. Results The prevalence of possible sarcopenia was 27.16% for men and 27.46% for women. Cognitive decline was significantly associated with sarcopenia status (β = -0.88, p < 0.001) and negatively associated with components of sarcopenia in male group. The results remained consistent in male after further adjusting for creatinine, uric acid, blood sugar, etc. Low cognitive function in female was only associated with low muscle strength (β = -0.85, p = 0.02). In addition, participants with possible sarcopenia had greater risk of cognitive decline than those without sarcopenia (OR = 1.41; 95% CI: 1.06-1.87). However, the same association was not significant in female group. Conclusion We suggest that sarcopenia might be associated with cognition function, with possible sarcopenia being significantly associated with higher cognition risk in China population, which providing a further rationale for timely recognition and management of sarcopenia.
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Affiliation(s)
- Hongzhen Du
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Miao Yu
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongmei Xue
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Xuning Lu
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Yaping Chang
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China
| | - Zengning Li
- Department of Nutrition, The First Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Nutrition and Health, Shijiazhuang, Hebei, China,*Correspondence: Zengning Li ✉
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Cao X, Yang B, Zhou J. Waist-to-calf circumstance ratio and cognitive function among Chinese older adults: Mediating roles of physical performance and social activity. Front Aging Neurosci 2023; 15:1166341. [PMID: 37139093 PMCID: PMC10150408 DOI: 10.3389/fnagi.2023.1166341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/23/2023] [Indexed: 05/05/2023] Open
Abstract
Background In light of the potentially detrimental effects of central fat and decreased muscle mass on cognitive function, it would be beneficial to learn more about the mediating mechanisms underpinning the association between the two. The purpose of this study is to determine the association between waist-to-calf circumstance ratio (WCR) and cognitive function, as well as to investigate whether physical performance and social activity mediate the relationship between WCR and cognitive function among older Chinese adults. Methods An analysis of 9,652 older Chinese adults was conducted during the 2018 wave of the Chinese Longitudinal Health Longevity Survey (CLHLS). The Mini-Mental State Examination (MMSE) and a self-reported scale were used to measure cognitive function, physical performance, and social activity, respectively. Multiple linear regression and mediation analyses were conducted. Results The findings suggest that a high WCR had a significant negative association with cognitive function (B = -0.535, 95% CI: -0.754, -0.317). Mediation analysis revealed that a high WCR influenced old adults' cognitive function in three ways: first, through the partial mediating effect of physical performance (B = -0.270; 95% CI: -0.340, -0.203); second, through the partial mediating effect of social activity (B = -0.035; 95% CI: -0.055, -0.017); and third, through the serial mediating effects of physical performance and social activity (B = -0.021, 95% CI: -0.029, -0.015). Conclusion The study results suggest the adverse impact of a high WCR on older adults' cognitive function, and the possible mechanisms of physical performance and social activity by which the association takes place. Multidimensional health and social interventions aimed at improving physical, social, and cognitive functioning among older adults with sarcopenic obesity are recommended.
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Chronic Disease Health Management Medical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Binfang Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China
- Hunan Chronic Disease Health Management Medical Research Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiansong Zhou
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental and Mental Diseases, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jiansong Zhou
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Yuan Z, Liu H, Zhang X, He Y, Gu S, Mo D, Wang S, Huang Z, Wu K, Zhou R, Zhong Q, Huang Y, Cao B, Chen H, Wu X. Role of uric acid as a biomarker of cognitive function in schizophrenia during maintenance period. Front Psychiatry 2023; 14:1123127. [PMID: 37032942 PMCID: PMC10073439 DOI: 10.3389/fpsyt.2023.1123127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Background Previous studies involving uric acid (UA) in some specialized disease populations have found that high UA is associated with enhanced patient function. The mechanism to explain this association may be that UA, an important antioxidant, exerts neuroprotective effects. Patients with schizophrenia (SCZ) have severe oxidative stress abnormalities, and cognitive impairment is a major obstacle to their rehabilitation. Only few studies have been conducted on UA and cognitive impairment in SCZ. This study aims to clarify the relationship between UA and cognitive impairment and explore whether UA could be used as a potential biological marker of cognition in SCZ during maintenance period. Methods A total of 752 cases of SCZ during maintenance period from Baiyun Jingkang Hospital were included. Cognition was measured using the Mini-Mental State Examination scale. UA was measured using the Plus method. The participants were grouped on the basis of UA to evaluate the association of cognition with low-normal (3.50-5.07 mg/dL for men, 2.50-4.19 mg/dL for women), middle-normal (5.07-6.39 mg/dL for men, 4.19-5.18 mg/dL for women), high-normal (6.39-7.00 mg/dL for men, 5.18-6.00 mg/dL for women), and high (>7.00 mg/dL for men, >6.00 mg/dL for women) levels of UA. Multiple logistic regression and linear regression models and restricted cubic spline (RCS) were utilized to evaluate the relationship. Results Uric acid was positively associated with cognitive function. Subgroup analyses showed that high UA was associated with enhanced cognition in participants with low anticholinergic cognitive burden (ACB). Conclusion Uric acid may be used as a simple objective biological indicator to assess cognition in SCZ during maintenance period.
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Affiliation(s)
- Zelin Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Huamin Liu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Xiaochun Zhang
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Yong He
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Shanyuan Gu
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Dan Mo
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Shaoli Wang
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Zhiwei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Keyi Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Qi Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Yining Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Bifei Cao
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Haowen Chen
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Xianbo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
- *Correspondence: Xianbo Wu, ; orcid.org/0000-0002-2706-9599
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11
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Zhao RR, Mavros Y, Meiklejohn J, Anderberg KA, Singh N, Kay S, Baker MK, Wang Y, Climstein M, O'Sullivan A, De Vos N, Baune BT, Blair SN, Simar D, Singh MAF. Effect of High Intensity Power Training on Cognitive Function in Older Adults with Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Study. J Gerontol A Biol Sci Med Sci 2022; 77:1975-1985. [PMID: 35436329 PMCID: PMC9536451 DOI: 10.1093/gerona/glac090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Indexed: 12/04/2022] Open
Abstract
We sought to determine the effects of 12 months of power training on cognition, and whether improvements in body composition, muscle strength, and/or aerobic capacity (VO2peak) were associated with improvements in cognition in older adults with type 2 diabetes (T2D). Participants with T2D were randomized to power training or low-intensity sham exercise control condition, 3 days per week for 12 months. Cognitive outcomes included memory, attention/speed, executive function, and global cognition. Other relevant outcomes included VO2peak, strength, and whole body and regional body composition. One hundred and three adults with T2D (mean age 67.9 years; standard deviation [SD] 5.9; 50.5% women) were enrolled and analyzed. Unexpectedly, there was a nearly significant improvement in global cognition (p = .05) in the sham group relative to power training, although both groups improved over time (p < .01). There were significant interactions between group allocation and body composition or muscle strength in the models predicting cognitive changes. Therefore, after stratifying by group allocation, improvements in immediate memory were associated with increases in relative skeletal muscle mass (r = 0.38, p = .03), reductions in relative body fat (r = −0.40, p = .02), and increases in knee extension strength were directly related to changes in executive function (r = −0.41, p = .02) within the power training group. None of these relationships were present in the sham group (p > .05). Although power training did not significantly improve cognition compared to low-intensity exercise control, improvements in cognitive function in older adults were associated with hypothesized improvements in body composition and strength after power training.
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Affiliation(s)
- Ren Ru Zhao
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,University of Longyan, Fujian, China.,Clinical Rehabilitation Research Group, Longyan Renmin Hospital, China
| | - Yorgi Mavros
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Jacinda Meiklejohn
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Kylie A Anderberg
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Nalin Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Shelley Kay
- Centre for Medical Psychology and Evidence Based Decision Making, Faculty of Medicine, University of Sydney, Camperdown, Australia
| | - Michael K Baker
- Research Ethics and Integrity, Australian Catholic University, Strathfield, Australia.,Clinical Exercise Physiology, School of Behavioural and Health Sciences, Australian Catholic University, Strathfield, Australia
| | - Yi Wang
- Lipid Metabolism & Cardiometabolic Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Mike Climstein
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Australia
| | - Anthony O'Sullivan
- Department of Endocrinology, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Nathan De Vos
- The Centre for STRONG Medicine, Balmain Hospital, Australia
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.,Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia.,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia
| | - Steven N Blair
- Exercise Science Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - David Simar
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Maria A Fiatarone Singh
- Exercise Health and Performance Faculty Research Group, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia.,Sydney Medical School, University of Sydney, Camperdown, Australia.,Jean Mayer USDA Human Nutrition Research Centre on Aging, Tufts University, Boston, USA
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12
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Oba K, Tamura Y, Ishikawa J, Suzuki H, Fujiwara Y, Tachibana A, Kodera R, Toyoshima K, Chiba Y, Araki A. Dynapenic abdominal obesity is associated with mild cognitive impairment in patients with cardiometabolic disease: a cross-sectional study. BMC Geriatr 2022; 22:255. [PMID: 35346081 PMCID: PMC8962154 DOI: 10.1186/s12877-022-02948-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/10/2022] [Indexed: 11/28/2022] Open
Abstract
Background Dementia is an important health issue for older people and requires early intervention in the mild cognitive impairment (MCI) stage to manage risk factors. Both dynapenia (DP) and abdominal obesity (AO) are associated with inflammation and oxidative stress, which may be involved in the pathogenesis of cognitive impairment. Therefore, in this cross-sectional study, we aimed to evaluate the association between MCI and dynapenic abdominal obesity (DAO), a combination of DP and AO. Methods A total of 417 older outpatients with cardiometabolic diseases without severe cognitive impairment were studied to compare cognitive function in four groups: control, DP, AO, and DAO groups. DAO was defined as the combination of DP (handgrip strength of < 28 kg and < 18 kg in men and women, respectively) and AO (waist circumference of ≥ 85 cm and ≥ 90 cm in men and women, respectively). MCI was defined as a score of ≤ 25 in the Japanese version of the Montreal Cognitive Assessment. Multiple regression analyses were performed to examine if MCI was independently associated with DAO, low handgrip strength, or high waist circumference. Results The DAO group obtained the lowest cognitive test scores and had the highest prevalence of MCI. Furthermore, after adjusting for covariates, the logistic regression analysis showed that patients in the DAO group were at an increased risk of MCI (odds ratio [OR] = 3.98, 95% confidence interval [CI]: 1.15–13.77). Further logistic regression analyses revealed that both low handgrip strength (OR = 2.19, 95% CI: 1.11–4.29) and high waist circumference (OR = 2.03, 95% CI: 1.03–3.99) were associated with MCI. Conclusions DAO, which can be easily diagnosed by a combination of handgrip strength and waist circumference, was associated with MCI in patents with cardiometabolic metabolic disease. This study suggests that screening for MCI in DAO patients could be important for early intervention of dementia prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02948-1.
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13
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Chang YS, Wu CH, Wang CJ, Lee HN, Wu YH. Obesity, sarcopenia, and depressive symptoms in patients with alzheimer's disease. TAIWANESE JOURNAL OF PSYCHIATRY 2022. [DOI: 10.4103/tpsy.tpsy_3_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Arokiasamy P, Selvamani Y, Jotheeswaran AT, Sadana R. Socioeconomic differences in handgrip strength and its association with measures of intrinsic capacity among older adults in six middle-income countries. Sci Rep 2021; 11:19494. [PMID: 34593926 PMCID: PMC8484588 DOI: 10.1038/s41598-021-99047-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/20/2021] [Indexed: 12/18/2022] Open
Abstract
Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity-a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO's Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.
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Affiliation(s)
- P Arokiasamy
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India
| | - Y Selvamani
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, 400088, India.
| | - A T Jotheeswaran
- Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
| | - Ritu Sadana
- Head, Ageing and Health, Department of Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
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15
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Tou NX, Wee SL, Pang BWJ, Lau LK, Jabbar KA, Seah WT, Chen KK, Ng TP. Associations of fat mass and muscle function but not lean mass with cognitive impairment: The Yishun Study. PLoS One 2021; 16:e0256702. [PMID: 34437646 PMCID: PMC8389410 DOI: 10.1371/journal.pone.0256702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sarcopenia and obesity are reportedly associated with risk of cognitive decline, and sarcopenic obesity (SO) heightens the risk, but the evidence is sparse and inconclusive. This study aimed to examine the association between SO and cognitive impairment. METHODS A total of 542 community-dwelling adults aged between 21 and 90 years were recruited. All participants were assessed for body composition (dual X-ray absorptiometry), handgrip strength (HGS), gait speed (GS), and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status). Sarcopenia was defined by the presence of low appendicular lean mass index (ALMI) and low HGS or low GS according to the 2019 Asian Working Group for Sarcopenia criteria, and obesity was defined based on the upper two quintiles of fat mass index (FMI). RESULTS Sarcopenia alone or in combination with obesity were not significantly associated with cognitive impairment after controlling for confounding variables. Obesity on its own was significantly associated with greater odds of impaired attention (OR: 2.05, 95%CI 1.12-3.82). Low ALMI was not associated, but low HGS, slow GS, and high FMI were individually associated with cognitive impairment: low HGS and immediate memory (OR: 1.91, 95% CI 1.04-3.49); low GS and immediate memory (OR: 2.17, 95% CI 1.26-3.72); high FMI and attention (OR: 2.06, 95% CI 1.22-3.51). Co-occurring high FMI with either low HGS or slow GS exacerbated the observed odds of global and domain-specific (attention, visuospatial) cognitive impairment. CONCLUSIONS Lean mass is not relevant, whereas muscle strength and physical performance or adiposity are relevant in defining sarcopenia or sarcopenic obesity in terms of their cognitive impacts.
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Affiliation(s)
- Nien Xiang Tou
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Shiou-Liang Wee
- Geriatric Education and Research Institute, Singapore, Singapore
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
- Program of Health Services and System Research, Duke-National University of Singapore Medical School, Singapore, Singapore
- * E-mail:
| | | | - Lay Khoon Lau
- Geriatric Education and Research Institute, Singapore, Singapore
| | | | - Wei Ting Seah
- Geriatric Education and Research Institute, Singapore, Singapore
| | | | - Tze Pin Ng
- Geriatric Education and Research Institute, Singapore, Singapore
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
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16
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Association between body mass index, its change and cognitive impairment among Chinese older adults: a community-based, 9-year prospective cohort study. Eur J Epidemiol 2021; 36:1043-1054. [PMID: 34370136 DOI: 10.1007/s10654-021-00792-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
To examine the association of baseline body mass index (BMI) and BMI change with cognitive impairment among older adults in China. The study included data from the Chinese Longitudinal Healthy Longevity Study, a national community-based prospective cohort study from 2002 to 2018. Baseline BMI and BMI change were available for 12,027 adults aged older than 65 years. Cognitive impairment was defined as Chinese version of the Mini Mental State Examination score lower than 18. Multivariable Cox proportional hazard model was used. Among 12,027 participants (mean age was 81.23 years old and 47.48% were male), the proportion of underweight, normal, overweight and obese at baseline was 33.87%, 51.39%, 11.39% and 3.34%, respectively. During an average of 5.9 years' follow-up, 3086 participants (4.35 per 100 person-years) with incident cognitive impairment were identified. Compared with normal weight group, adjusted hazard ratio (AHR) for cognitive impairment was 0.86 (95% CI 0.75-0.99) among overweight group, whereas corresponding AHR was 1.02 (95% CI 0.94-1.10) in underweight and 1.01 (95% CI 0.80-1.28) in obese participants. Large weight loss (< -10%) was significantly associated with an increased risk of cognitive impairment (AHR, 1.42, 95% CI 1.29-1.56), compared to stable weight status group (-5% ~ 5%). In the restricted cubic spline models, BMI change showed a reverse J-shaped association with cognitive impairment. BMI-defined overweight, but not obesity, was associated with a lower risk of cognitive impairment among elderly Chinese adults, while large weight loss was associated with an increased risk. These findings are consistent with weight loss in the prodromal phase of dementia.
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17
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Hoffmann J, Busse S, von Hoff F, Borucki K, Frodl T, Busse M. Association Between Homocysteine and Vitamin Levels in Demented Patients. J Alzheimers Dis 2021; 81:1781-1792. [PMID: 33998538 DOI: 10.3233/jad-201481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although it is known that the nutritional status among elderly persons and, in particular, patients with dementia, is compromised, malnutrition that results in insufficient uptake of several vitamins is often not diagnosed. OBJECTIVE An elevated homocysteine level is a known strong risk factor for vascular dementia (VaD) and Alzheimer's disease (AD). Several B vitamins are involved in the metabolism of homocysteine. Therefore, we investigated the serum levels of vitamin B1, vitamin B6, folate, and vitamin B12 in 97 patients with mild cognitive impairment (MCI) or different forms of dementia and 54 elderly control persons without dementia. RESULTS Compared to aged non-demented people, vitamins B1, B6, B12, and folate were decreased in serum of patients with AD, and patients with Lewy body dementia had reduced vitamin B12 level. Vitamin B6 was diminished in VaD. Patients with frontotemporal dementia showed no alterations in vitamin levels. Age was identified as an important factor contributing to the concentrations of vitamin B1 and B6 in serum, but not vitamin B12 and folate. Increased levels of total homocysteine were detected especially in MCI and AD. Homocysteine correlated negatively with levels of vitamins B6, B12, and folate and positively with Q Albumin. CONCLUSION Our data suggest that despite increased homocysteine already present in MCI, vitamin levels are decreased only in dementia. We propose to determine the vitamin levels in patients with cognitive decline, but also elderly people in general, and recommend supplementing these nutrients if needed.
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Affiliation(s)
- Jessica Hoffmann
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Stefan Busse
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Franz von Hoff
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Katrin Borucki
- Institute for Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany
| | - Mandy Busse
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Magdeburg, Magdeburg, Germany.,Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
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18
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Shields GS, Deer LK, Hastings PD, Hostinar CE. Adiposity, Inflammation, and Working Memory: Evidence for a Vicious Cycle. Brain Behav Immun Health 2021; 13. [PMID: 33899030 PMCID: PMC8061900 DOI: 10.1016/j.bbih.2021.100202] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Overweight and obesity constitute the fifth leading cause of preventable deaths worldwide. One pathway through which excess weight contributes to poor health outcomes is via inflammatory activity and changes in cognitive processes. Prior theory has proposed a vicious cycle whereby obesity potentiates inflammatory activity, which alters cognitive processes such as working memory, which in turn leads to a reduced ability to self-regulate and therefore manage weight. However, to date no longitudinal studies have examined this potential dynamic. In the current study, we addressed this gap by assessing the relations among fat mass, C-reactive protein (CRP), and working memory across time in a large sample of 8536 children followed through adolescence in the Avon Longitudinal Study of Parents and Children in the United Kingdom. Adiposity was quantified via dual emission x-ray absorptiometry (DEXA) at ages 9 and 15.5 years old, and inflammatory activity was indexed via circulating serum C-reactive protein (CRP) levels assessed with a high-sensitivity assay at those same ages. Working memory was assessed between these two time points, at age 10, permitting examination of the temporal relations between working memory, adiposity, and inflammatory activity. As hypothesized, we found that fat mass predicted later poor working memory, and this association was statistically mediated by CRP. Further, we found that poor working memory predicted greater subsequent fat mass and CRP, and the link between working memory and subsequent CRP was partially mediated by fat mass. These results thus could be taken to suggest the existence of a vicious cycle of mutually amplifying adiposity, inflammatory activity, and poor working memory over time. Adiposity and inflammatory activity (CRP) was measured at ages 9 and 15.5 yrs. Working memory was assessed at age 10 yrs. Adiposity predicted working memory, and this association was mediated by CRP. Working memory predicted later adiposity and CRP, this was mediated by adiposity.
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Affiliation(s)
- Grant S. Shields
- Center for Mind and Brain, University of California, Davis, CA, United States
| | - LillyBelle K. Deer
- Center for Mind and Brain, University of California, Davis, CA, United States
- Department of Psychology, University of California, Davis, CA, United States
| | - Paul D. Hastings
- Center for Mind and Brain, University of California, Davis, CA, United States
- Department of Psychology, University of California, Davis, CA, United States
| | - Camelia E. Hostinar
- Center for Mind and Brain, University of California, Davis, CA, United States
- Department of Psychology, University of California, Davis, CA, United States
- Corresponding author. Center for Mind and Brain, University of California, Davis, CA, United States.
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19
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Skeletal Muscle Health and Cognitive Function: A Narrative Review. Int J Mol Sci 2020; 22:ijms22010255. [PMID: 33383820 PMCID: PMC7795998 DOI: 10.3390/ijms22010255] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/15/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022] Open
Abstract
Sarcopenia is the loss of skeletal muscle mass and function with advancing age. It involves both complex genetic and modifiable risk factors, such as lack of exercise, malnutrition and reduced neurological drive. Cognitive decline refers to diminished or impaired mental and/or intellectual functioning. Contracting skeletal muscle is a major source of neurotrophic factors, including brain-derived neurotrophic factor, which regulate synapses in the brain. Furthermore, skeletal muscle activity has important immune and redox effects that modify brain function and reduce muscle catabolism. The identification of common risk factors and underlying mechanisms for sarcopenia and cognition may allow the development of targeted interventions that slow or reverse sarcopenia and also certain forms of cognitive decline. However, the links between cognition and skeletal muscle have not been elucidated fully. This review provides a critical appraisal of the literature on the relationship between skeletal muscle health and cognition. The literature suggests that sarcopenia and cognitive decline share pathophysiological pathways. Ageing plays a role in both skeletal muscle deterioration and cognitive decline. Furthermore, lifestyle risk factors, such as physical inactivity, poor diet and smoking, are common to both disorders, so their potential role in the muscle-brain relationship warrants investigation.
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20
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Teoh RJJ, Mat S, Khor HM, Kamaruzzaman SB, Tan MP. Falls, frailty, and metabolic syndrome in urban dwellers aged 55 years and over in the Malaysian elders longitudinal research (MELoR) study - a cross-sectional Study. Postgrad Med 2020; 133:351-356. [PMID: 33143493 DOI: 10.1080/00325481.2020.1842026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES While metabolic syndrome, falls, and frailty are common health issues among older adults which are likely to be related, the potential interplay between these three conditions has not previously been investigated. We investigated the relationship between metabolic syndrome with falls, and the role of frailty markers in this potential relationship, among community-dwelling older adults. METHODS Data from the first wave Malaysian Elders Longitudinal Research (MELoR) study comprising urban dwellers aged 55 years and above were utilized. Twelve-month fall histories were established during home-based, computer-assisted interviews which physical performance, anthropometric and laboratory measures were obtained during a hospital-based health check. Gait speed, exhaustion, weakness, and weight loss were employed as frailty markers. RESULTS Data were available for 1415 participants, mean age of 68.56 ± 7.26 years, 57.2% women. Falls and metabolic syndrome were present in 22.8% and 44.2%, respectively. After adjusting for age, sex, and multiple comorbidities, metabolic syndrome was significantly associated with falls in the sample population [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.03; 1.72]. This relationship was attenuated by the presence of slow gait speed, but not exhaustion, weakness, or weight loss. CONCLUSION Metabolic syndrome was independently associated with falls among older adults, and this relationship was accounted for by the presence of slow gait speed. Future studies should determine the value of screening for frailty and falls with gait speed in older adults with metabolic syndrome as a potential fall prevention measure.
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Affiliation(s)
- Ru Jian Jonathan Teoh
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hui Min Khor
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia
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21
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Batsis JA, Haudenschild C, Roth RM, Gooding TL, Roderka MN, Masterson T, Brand J, Lohman MC, Mackenzie TA. Incident Impaired Cognitive Function in Sarcopenic Obesity: Data From the National Health and Aging Trends Survey. J Am Med Dir Assoc 2020; 22:865-872.e5. [PMID: 34248422 DOI: 10.1016/j.jamda.2020.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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.
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Affiliation(s)
- John A Batsis
- Geisel School of Medicine at Dartmouth, Hanover, NH
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Christian Haudenschild
- Geisel School of Medicine at Dartmouth, Hanover, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
| | - Robert M Roth
- Geisel School of Medicine at Dartmouth, Hanover, NH
- Neuropsychology Program, Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Tyler L Gooding
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | | | | | - John Brand
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Matthew C Lohman
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Todd A Mackenzie
- Geisel School of Medicine at Dartmouth, Hanover, NH
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH
- The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH
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Matsushita T, Nishioka S, Taguchi S, Yamanouchi A, Nakashima R, Wakabayashi H. Sarcopenic Obesity and Activities of Daily Living in Stroke Rehabilitation Patients: A Cross-Sectional Study. Healthcare (Basel) 2020; 8:healthcare8030255. [PMID: 32781673 PMCID: PMC7551564 DOI: 10.3390/healthcare8030255] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022] Open
Abstract
Reports investigating the relationship between sarcopenic obesity and activities of daily living in older patients with stroke were limited. This study aimed to examine the prevalence of sarcopenic obesity and its association with activities of daily living in older post-stroke patients in convalescent rehabilitation wards. This study was performed in older post-stroke patients admitted to convalescent rehabilitation wards between January 2017 and March 2019. Sarcopenia was diagnosed based on the skeletal muscle mass index and hand grip strength according to the criteria of the 2019 Asian Working Group for Sarcopenia. Obesity was diagnosed according to the body fat percentage; ≥27% in men, ≥38% in women. The primary outcome was the Functional Independence Measure (FIM) score upon admission, which was analyzed using multiple linear regression. In total, 376 participants (women 44%; mean age 77.5 years) were analyzed and classified as normal (22%), simple obesity (17%), sarcopenia without obesity (32%), and sarcopenic obesity (28%). The presence of sarcopenic obesity was independently associated with the FIM score (95% CI, -16.157 to -5.353), whereas simple obesity and sarcopenia without obesity were not. In conclusion, sarcopenic obesity was independently associated with lower activities of daily living capability in older patients with stroke.
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Affiliation(s)
- Tatsuya Matsushita
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan
- Correspondence: ; Tel.: +81-95-818-2002
| | - Shiori Taguchi
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Anna Yamanouchi
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Ryusei Nakashima
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki 850-0854, Japan; (T.M.); (S.T.); (A.Y.); (R.N.)
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women’s Medical University Hospital, Tokyo 162-8666, Japan;
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The prevalence of sarcopenic obesity and its association with cognitive performance in type 2 diabetes in Singapore. Clin Nutr 2020; 39:2274-2281. [DOI: 10.1016/j.clnu.2019.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/05/2019] [Accepted: 10/15/2019] [Indexed: 12/25/2022]
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Association between Lower Extremity Skeletal Muscle Mass and Impaired Cognitive Function in Type 2 Diabetes. Sci Rep 2020; 10:2956. [PMID: 32076075 PMCID: PMC7031513 DOI: 10.1038/s41598-020-59914-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/04/2020] [Indexed: 01/28/2023] Open
Abstract
Lower extremity skeletal muscle mass (LESM) in Type 2 Diabetes (T2D) has been linked to adverse clinical events, but it is not known whether it is associated with cognitive difficulties. We conducted a cross-sectional study on 1,235 people (mean age 61.4 ± 8.0 years) with T2D under primary and secondary care in Singapore. Bioelectrical impedance analyses (BIA) measures of upper extremity skeletal muscle mass (UESM), LESM and appendicular skeletal muscle index (SMI) were related to the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) measures of cognition, in multiple linear regression. In multivariable models, tertile 1 LESM (b = −2.62 (−3.92 to −1.32)) and tertile 2 LESM (b = −1.73 (−2.73 to −0.73)), referenced to tertile 3) were significantly associated with decreased RBANS total score. Significant associations of LESM with cognitive domain performances were observed for tertile 1 (b = −3.75 (−5.98 to −1.52)) and tertile 2 (b = −1.98 (−3.69 to −0.27)) with immediate memory, and for tertile 1 (b = −3.05 (−4.86 to −1.24)) and tertile 2 (b = −1.87 (−3.25 to −0.48)) with delayed memory, and for tertile 1 (b = −2.99 (−5.30 to −0.68)) with visuospatial/constructional ability. Tertile 1 SMI (b = −1.94 (−3.79 to −0.08) and tertile 2 SMI (b = −1.75 (−3.14 to −0.37)) were also associated with delayed memory. There were no associations between UESM with cognitive performance. Lower LESM may be a useful marker of possible co-occuring cognitive dysfunction.
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Kim JY, Oh S, Park HY, Jun JH, Kim HJ. Comparisons of different indices of low muscle mass in relationship with cardiometabolic disorder. Sci Rep 2019; 9:609. [PMID: 30679721 PMCID: PMC6345970 DOI: 10.1038/s41598-018-37347-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/20/2018] [Indexed: 12/14/2022] Open
Abstract
This study aimed to evaluate the most valid index among various indices of low muscle mass in assessing cardiometabolic risks in a Korean population. Appendicular lean mass index (ALMI, kg/m2), fat mass index (FMI, kg/m2), FMI-adjusted ALMI (ALMfmi), ratio of ALM to weight index (ALMwt), ratio of ALM to body mass index (ALMbmi) and ratio of ALM to truncal fat index (ALMtrunkfat) were measured by dual energy X-ray absorptiometry in 17,870 participants from 2008 to 2011. We adopted all the aforementioned indices of low muscle mass expressed as sex- and age-specific standard deviation scores (Z-scores). Low muscle mass for age was defined as Z-score <-1. The prevalence of low muscle mass was approximately 16% across all indices. Low muscle mass defined by ALMI had low muscle mass and low fat mass, and ALMfmi had low muscle mass at the same FMI. However, low muscle mass defined by ALMwt, ALMbmi and ALMtrunkfat had similar muscle mass with high FMI. The receiver operating characteristic curve in metabolic syndrome showed that the ALMtrunkfat was 0.74 in male and 0.69 in female, indicating that ALMtrunkfat was the best discrimination index for metabolic syndrome. This study showed that ALMtrunkfat could be a useful indicator for screening cardiometabolic risk factors, particularly in normal or overweight Asian population.
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Affiliation(s)
- Ju Young Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hwa Yeon Park
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hye Jun
- Deparment of Family Medicine, Chamjoeun Hospital, Gwangju, Korea
| | - Hwa Jung Kim
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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SILVA NETO LS, MEDEIROS A, TRAVASSOS A, OSÓRIO NB, NUNES GF. Association between sarcopenic obesity, muscle strength and risk of cardiovascular and cardiometabolic diseases in the elderly: A systematic review. REV NUTR 2019. [DOI: 10.1590/1678-9865201932e180237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT To describe the findings in the literature about the association between sarcopenic obesity, muscle strength and risk factors and/or cardiometabolic or cardiovascular diseases in the elderly. A research was carried out in the following databases: Medical Literature Analysis and Retrievel System Online, Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Latin America and Caribbean Health Sciences Literature) and Capes Journals, using the following search terms in English, Spanish and Portuguese: “obesity sarcopenic” OR “sarcopenic obesity” in the title AND “cardiometabolic disease” OR “cardiovascular disease” OR “metabolic syndrome” OR “insulin resistance” in the title/abstract AND “aged” in all fields of search with the variation of the “muscle strength” descriptor in all fields of this research. Articles were selected according to the following exclusion criteria: studies evaluating only sarcopenia and the risk of cardiometabolic/cardiovascular disease in the elderly, studies evaluating only obesity and the risk of cardiometabolic/cardiovascular disease in the elderly, studies that did not present the used method, studies in animals and studies that were not in Portuguese, English or Spanish. The researchers of the present study found a heterogeneity of methods for the identification of sarcopenic obesity, and a transversal cohort was used in most of the studies. It was possible to verify the association of sarcopenic obesity with risk factors and/or cardiometabolic or cardiovascular disease. Sarcopenic obesity is associated with risk factors and/or cardiometabolic or cardiovascular disease in the elderly. Establishing a robust definition of sarcopenic obesity in the elderly is necessary for further clinical studies and interventions.
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Wang H, Hai S, Liu YX, Cao L, Liu Y, Liu P, Yang Y, Dong BR. Associations between Sarcopenic Obesity and Cognitive Impairment in Elderly Chinese Community-Dwelling Individuals. J Nutr Health Aging 2019; 23:14-20. [PMID: 30569063 DOI: 10.1007/s12603-018-1088-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION This study aimed to estimate the prevalence of sarcopenic obesity (SO) and the association between cognitive impairment and SO in a cohort of elderly Chinese community-dwelling individuals. METHODS A total of 948 elderly Chinese community-dwelling individuals aged 60-92 years were recruited. The participants were categorized into the following four groups according to their sarcopenia and obesity status: sarcopenic obese, sarcopenic, obese and non-sarcopenic, and non-obese group. Sarcopenia was defined as appendicular skeletal muscle index of <7.0 kg/m2 in men and <5.7 kg/m2 in women; obesity was defined as values greater than the upper two quintiles for body fat percentage stratified by gender of the study population; cognitive impairment was measured using the Mini-Mental State Examination and defined as a score of <24. RESULTS A total of 945 participants were included in the statistical analyses with a mean age of 68.76 ± 6.50 years. The prevalence of SO was 6.0% (7.3% in men and 4.8% in women). The sarcopenic obese (odds ratio [OR]: 2.550, 95% confidence interval [CI], 1.196-5.435) and obese (ORs: 2.141, 95% CI, 1.230-3.728) groups had significantly increased risk for cognitive impairment in fully adjusted model, respectively. CONCLUSION The SO prevalence in elderly Chinese community-dwelling individuals was relatively low (6.0%). The present study suggested SO was independently associated with cognitive impairment.
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Affiliation(s)
- H Wang
- Birong Dong, Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, China, E-mail address:
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Levine ME, Harrati A, Crimmins EM. Predictors and Implications of Accelerated Cognitive Aging. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2018; 64:83-101. [PMID: 31007841 PMCID: PMC6469682 DOI: 10.1080/19485565.2018.1552513] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Aging is a major risk factor for both normal and pathological cognitive decline. However, individuals vary in their rate of age-related decline. We developed an easily interpretable composite measure of cognitive age, and related both the level of cognitive age and cognitive slope to sociodemographic, genetic, and disease indicators and examine its prediction of dementia transition. Using a sample of 19,594 participants from the Health and Retirement Study, cognitive age was derived from a set of performance tests administered at each wave. Our findings reveal different conclusions as they relate to levels versus slopes of cognitive age, with more pronounced differences by sex and race/ethnicity for absolute levels of cognitive decline rather than for rates of declines. We also find that both level and slope of cognitive age are inversely related to education, as well as increased for persons with APOE ε4 and/or diabetes. Finally, results show that the slope in cognitive age predicts subsequent dementia among non-demented older adults. Overall, our study suggests that this measure is applicable to cross-sectional and longitudinal studies on cognitive aging, decline, and dementia with the goal of better understanding individual differences in cognitive decline.
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Affiliation(s)
- Morgan E. Levine
- Department of Pathology, Yale School of Medicine, New Haven, CT 06520, USA
- Department of Epidemiology, Yale School of Public Health, New Haven, CT 06520, USA
| | - Amal Harrati
- Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Eileen M. Crimmins
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
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Jeong SM, Choi S, Kim K, Kim SM, Kim S, Park SM. Association among handgrip strength, body mass index and decline in cognitive function among the elderly women. BMC Geriatr 2018; 18:225. [PMID: 30249201 PMCID: PMC6154935 DOI: 10.1186/s12877-018-0918-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 09/13/2018] [Indexed: 01/10/2023] Open
Abstract
Background The association between handgrip strength combined with body mass index (BMI) and cognitive impairment has not been thoroughly examined. We aimed to investigate whether the relationship between handgrip strength and risk of cognitive impairment is altered by the presence of obesity in older women. Methods A total of 544 older women aged over 65 years without cognitive impairment from the Korean Longitudinal Study of Aging (KLoSA) were included in the study. Handgrip strength was classified in a binary manner (weak or strong) or in tertiles and obesity was defined as a BMI ≥ 25 kg/m2, in accordance with the Asia-Pacific World Health Organization criteria. Incident cognitive impairment was defined as a Korean Mini-mental State Examination (K-MMSE) score of less than 24 after eight years of follow-up. Results Strong handgrip strength was associated with reduced likelihood of developing cognitive impairment compared to weak handgrip strength in obese women (adjusted odds ratio, aOR 0.23, 95% confidence interval, CI 0.08–0.66). The highest tertile of handgrip strength was associated with reduced risk of incident cognitive impairment (aOR 0.16, 95% CI 0.04–0.70), compared to the lowest tertile of handgrip strength in obese women, with a significant linear trend (p for trend = 0.016). Furthermore, the highest tertile of handgrip strength was significantly associated with smaller decline in K-MMSE scores compared to the lowest tertile of handgrip strength in obese women (p value = 0.009). There was no association between handgrip strength and incident cognitive impairment in non-obese women. Conclusions Strong handgrip strength was associated with reduced risk of cognitive impairment among obese women, but not in non-obese women. Handgrip strength may be a simple and useful marker for predicting future cognitive impairment among obese women. Electronic supplementary material The online version of this article (10.1186/s12877-018-0918-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - Kyuwoong Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, 101 Daehak-ro, Jongno-gu, Seoul, South Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, 101 Daehak-ro, Jongno-gu, Seoul, South Korea
| | - Sujin Kim
- Korea Institute for Health and Social Affairs, Sejong, South Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, South Korea. .,Department of Biomedical Sciences, Seoul National University Graduate School, 101 Daehak-ro, Jongno-gu, Seoul, South Korea.
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30
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Abstract
BACKGROUND Sarcopenia and obesity both negatively impact health including cognitive function. Their coexistence, however, can pose an even higher threat likely surpassing their individual effects. We assessed the relationship of sarcopenic obesity with performance on global- and subdomain-specific tests of cognition. PATIENTS AND METHODS The study was a cross-sectional analysis of data from a series of community-based aging and memory studies. The sample consisted of a total of 353 participants with an average age of 69 years with a clinic visit and valid cognitive (eg, Montreal Cognitive Assessment, animal naming), functional (eg, grip strength, chair stands), and body composition (eg, muscle mass, body mass index, percent body fat) measurements. RESULTS Sarcopenic obesity was associated with the lowest performance on global cognition (Est.Definition1=-2.85±1.38, p=0.039), followed by sarcopenia (Est.Definition1=-1.88±0.79, p=0.017) and obesity (Est.Definition1=-1.10±0.81, p=0.175) adjusted for sociodemographic factors. The latter, however, did not differ significantly from the comparison group consisting of older adults with neither sarcopenia nor obesity. Subdomain-specific analyses revealed executive function (Est.Definition1=-1.22±0.46 for sarcopenic obesity; Est.Definition1=-0.76±0.26 for sarcopenia; Est.Definition1=-0.52±0.27 for obesity all at p<0.05) and orientation (Est.Definition1=0.59±0.26 for sarcopenic obesity; Est.Definition1=-0.36±0.15 for sarcopenia; Est.Definition1=-0.29±0.15 all but obesity significant at p<0.05) as the individual cognitive skills likely to be impacted. Potential age-specific and depression effects are discussed. CONCLUSION Sarcopenia alone and in combination with sarcopenic obesity can be used in clinical practice as indicators of probable cognitive impairment. At-risk older adults may benefit from programs addressing loss of cognitive function by maintaining/improving strength and preventing obesity.
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Affiliation(s)
- Magdalena I Tolea
- Charles E. Schmidt College of Medicine, Department of Integrated Medical Sciences, Comprehensive Center for Brain Health, Florida Atlantic University, Boca Raton, FL, USA
| | - Stephanie Chrisphonte
- Charles E. Schmidt College of Medicine, Department of Integrated Medical Sciences, Comprehensive Center for Brain Health, Florida Atlantic University, Boca Raton, FL, USA
| | - James E Galvin
- Charles E. Schmidt College of Medicine, Department of Integrated Medical Sciences, Comprehensive Center for Brain Health, Florida Atlantic University, Boca Raton, FL, USA
- Christine E. Lynn College of Nursing, Louis and Anne Green Memory and Wellness Center, Florida Atlantic University, Boca Raton, FL, USA
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Gogniat MA, Robinson TL, Mewborn CM, Jean KR, Miller LS. Body mass index and its relation to neuropsychological functioning and brain volume in healthy older adults. Behav Brain Res 2018; 348:235-240. [PMID: 29689374 DOI: 10.1016/j.bbr.2018.04.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 12/27/2022]
Abstract
Obesity is a growing concern worldwide because of its adverse health effects, including its negative impact on cognitive functioning. This concern is especially relevant for older adults, who are already likely to experience some cognitive decline and loss of brain volume due to aging, (Gea et al., 2002). However, there is some evidence that higher body mass index (BMI) may actually be protective in later life (Hughes et al., 2009; Luchsinger et al., 2007; Nilsson and Nilsson, 2009; Sturman et al., 2008). Therefore, the purpose of the current study was to assess the relationship between BMI and neuropsychological functioning in older adults, and concurrently the relationship between BMI and brain volume. Older adults (N = 88) reported height and weight to determine BMI (M = 26.5) based on Centers for Disease Control and Prevention (CDC) guidelines. Cognitive function was assessed with the Repeatable Battery for Assessment of Neuropsychological Status (RBANS). Brain volume measurements were evaluated via structural MRI. Results indicated no association between BMI and neuropsychological functioning. There was a significant association between BMI and total grey matter volume while controlling for age and years of education (β = 0.208, p = .026, ΔR2 = 0.043), indicating that as BMI increased, brain volume in these areas modestly increased. However, these results did not survive multiple comparison corrections and were further attenuated to near significance when sex was explicitly added as an additional covariate. Nevertheless, while replication is clearly needed, these results suggest that moderately greater BMI in later life may modestly attenuate concomitant grey matter volume decline.
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Affiliation(s)
| | | | | | | | - L Stephen Miller
- University of Georgia, Department of Psychology, Athens, GA, USA; University of Georgia, Bio-Imaging Research Center, Athens, GA, USA.
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Nunez Lopez YO, Messi ML, Pratley RE, Zhang T, Delbono O. Troponin T3 associates with DNA consensus sequence that overlaps with p53 binding motifs. Exp Gerontol 2018; 108:35-40. [PMID: 29596868 DOI: 10.1016/j.exger.2018.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 02/25/2018] [Accepted: 03/09/2018] [Indexed: 12/25/2022]
Abstract
We recently reported that in addition to its classical cytoplasmic location, the fast skeletal muscle Troponin T3 (TnT3) shuttles to the nucleus, where it appears to perform nonclassical transcription regulatory functions. Importantly, changes in the composition of the nucleus-localized pool of TnT3 and its fragments contribute to age-dependent muscle damage and wasting. Here, using ChIP-Seq, we demonstrate that TnT3 associates with DNA consensus sequences including the TGCCT motif, which is required for p53 binding to the promoter area of p53-related genes. Gene set enrichment analysis further demonstrated that the p53 pathway was the most significantly enriched pathway among genes annotated to the TnT3 ChIP-Seq peaks. We further demonstrated a strong correlation (r = 0.78, P = 1 × 10-4) between the expression levels of TNNT3 and TP53-inducible ribonucleotide reductase regulatory subunit M2B (RRM2B) in skeletal muscle tissue of 21 lean non-diabetic human subjects and a significant (P < 0.05) reduction in the levels of both gene transcripts in the third age-tertile group [42.3-70 years of age (yoa)] as compared to the second age-tertile (31.3-42.3 yoa). Of note, both TNNT3 and RRM2B expression levels negatively associated with total body fat mass (each with r = 0.49, P < 0.05), whereas RRM2B positively correlated with pancreatic β cell function (rRRM2B~HOMA-B = 0.47, P = 0.047). This work suggests that reduced TNNT3 gene expression is another mechanism leading to reduced TnT3 and excitation-contraction coupling with aging. Consequently, TnT3 appears to contribute to age-related sarcopenia and possibly other age-related deficiencies such as muscle insulin resistance and β cell dysfunction by interacting with TnT3-binding sequences in the promoter area of p53-related genes, among others, and consequently modulating the transcriptional regulation of these target genes.
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Affiliation(s)
- Yury O Nunez Lopez
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL 32804, United States.
| | - Maria Laura Messi
- Departments of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Richard E Pratley
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL 32804, United States
| | - Tan Zhang
- Departments of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Osvaldo Delbono
- Departments of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
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Perna S, Peroni G, Faliva MA, Bartolo A, Naso M, Miccono A, Rondanelli M. Sarcopenia and sarcopenic obesity in comparison: prevalence, metabolic profile, and key differences. A cross-sectional study in Italian hospitalized elderly. Aging Clin Exp Res 2017; 29:1249-1258. [PMID: 28233283 DOI: 10.1007/s40520-016-0701-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 12/15/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of this study is to identify the prevalence, assess the metabolic profile, and key differences (versus healthy) in a cohort of subjects with sarcopenia (S) and in sarcopenic obesity (SO) hospitalized elderly. METHODS A standardized comprehensive geriatric assessment was performed. We enrolled 639 elderly subjects (196 men, 443 women) with a mean age of 80.90 ± 7.77 years. Analysis of variance and a multinomial logistic regression analysis adjusting for covariates were used to assess the differences between groups. RESULTS The prevalence of (S) was 12.42% in women and 23.47% in men. (SO) was 8.13% in women and 22.45% in men. Data showed that either groups had a functional impairment (Barthel index < 50 points). (S) had the mean value of erythrocyte sedimentation rate (ESR) (>15 mm/h), CPR (>0.50 mg/dl) homocysteine (>12 micromol/l), and hemoglobin (<12 g/dl). Ferritin level over the range (>145 mcg/dl) was detected in either cohort (due to inflammation). (SO) had glycemia (>110 mg/dl). Key differences in (S) cohort (versus healthy) were a reduction in functional impairment (p < 0.001), an increase in white blood cell (p < 0.01), a decrease in iron level (p < 0.05), in electrolytes balance (Na: p < 0.01 and Cl: p < 0.01), and tyroid function (TSH: p < 0.001). In addition, (S) had higher state of inflammation (erythrocyte sedimentation rate: p < 0.05 and C-reactive protein: p < 0.01), and an increase of risk of fractures (FRAX: OR 1.07; p < 0.001), risk of malnutrition (mini nutritional assessment: p < 0.001), and risk of edema (extra cellular water: p < 0.001). In (SO) cohort, an increase in white blood cell (p < 0.001) and erythrocyte sedimentation rate (p < 0.05) was observed. CONCLUSIONS (S) subjects appears more vulnerable than (SO). Sarcopenia is closely linked to an increase in the risk of hip-femur fractures, inflammation, edema, and malnutrition. The (SO) subjects seem to benefit from the "obesity paradox."
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Won H, Abdul Manaf Z, Mat Ludin AF, Shahar S. Wide range of body composition measures are associated with cognitive function in community-dwelling older adults. Geriatr Gerontol Int 2016; 17:554-560. [PMID: 27231255 DOI: 10.1111/ggi.12753] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 11/23/2015] [Accepted: 01/04/2016] [Indexed: 12/29/2022]
Abstract
AIM Studies of the association between body composition, both body fat and body muscle, and cognitive function are rarely reported. The aim of the present study was to determine the association between a wide range of body composition measures with cognitive function in older adults. METHODS A total of 2322 Malaysian older adults aged 60 years and older were recruited using multistage random sampling in a population-based cross-sectional study. Out of 2322 older adults recruited, 2309 (48% men) completed assessments on cognitive function and body composition. Cognitive functions were assessed using the Malay version of the Mini-Mental State Examination, the Bahasa Malaysia version of Montreal Cognitive Assessment, Digit Span Test, Digit Symbol Test and Rey Auditory Verbal Learning Test. Body composition included body mass index, mid-upper arm circumference, waist circumference, calf circumference, waist-to-hip ratio, percentage body fat and skeletal muscle mass. RESULTS The association between body composition and cognitive functions was analyzed using multiple linear regression. After adjustment for age, education years, hypertension, hypercholesterolemia, diabetes mellitus, depression, smoking status and alcohol consumption, we found that calf circumference appeared as a significant predictor for all cognitive tests among both men and women (P < 0.05), except for the Rey Auditory Verbal Learning Test. Waist-to-hip ratio was detected as a significant predictor for all cognitive tests among women (P < 0.05), but was only a significant predictor for the Bahasa Malaysia version of Montreal Cognitive Assessment among men (P < 0.05). CONCLUSIONS These results suggest that there is a need to maintain muscle mass and lower adipose tissue among older adults for optimal cognitive function. Geriatr Gerontol Int 2017; 17: 554-560.
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Affiliation(s)
- Huiloo Won
- Nutrition Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zahara Abdul Manaf
- Dietetics Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Biomedical Science Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Gunathilake R, Oldmeadow C, McEvoy M, Inder KJ, Schofield PW, Nair BR, Attia J. The Association Between Obesity and Cognitive Function in Older Persons: How Much Is Mediated by Inflammation, Fasting Plasma Glucose, and Hypertriglyceridemia? J Gerontol A Biol Sci Med Sci 2016; 71:1603-1608. [DOI: 10.1093/gerona/glw070] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 03/30/2016] [Indexed: 11/13/2022] Open
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Carias S, Castellanos AL, Vilchez V, Nair R, Dela Cruz AC, Watkins J, Barrett T, Trushar P, Esser K, Gedaly R. Nonalcoholic steatohepatitis is strongly associated with sarcopenic obesity in patients with cirrhosis undergoing liver transplant evaluation. J Gastroenterol Hepatol 2016; 31:628-33. [PMID: 26399838 PMCID: PMC6615558 DOI: 10.1111/jgh.13166] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sarcopenia is the most common complication of cirrhosis and adversely affects quality of life and outcomes before, during, and after liver transplantation. We studied predictors of sarcopenia and sarcopenic obesity in patients with cirrhosis undergoing liver transplant (LT) evaluation. METHODS A retrospective analysis of 207 adult cirrhotic patients that underwent LT from January 2008 to December 2013 was performed at our institution. RESULTS Two hundred seven patients were evaluated, 68% were male with a mean age of 54 ± 8 years. The most common etiology of cirrhosis was alcoholic liver disease (38.6%), followed by chronic hepatitis C (38.2%), nonalcoholic steatohepatitis (NASH) (21.7%), and hepatocellular carcinoma (HCC) (24.6%). The mean body mass index of the cohort was of 30.1 ± 5.7 kg/m(2) . Forty-eight percent of these patients were obese. Of the 207 patients, 88% had computed tomographic (CT) scans within 90 days before transplant; of these, 59% had sarcopenia found during LT evaluation. Of the patients with pretransplant sarcopenia, 59 had CT scan at 6 months posttransplant and 56 (95%) remained sarcopenic. Of the 56 patients who had sarcopenia at 6 months, 31 had available CT scans at 1 year, and 100% persisted with sarcopenia. These 31 subjects had a mean skeletal muscle index of 35 at 6 months and 36 at 1 year. SO was found in 41.7% of our patients. On multivariable regression analysis, obesity and age were found to be independently associated with pretransplant sarcopenia after controlling for gender and alcohol liver disease diagnosis (P = 0.00001, odds ratio [OR] 0.22, and P = 0.008, OR 2.0, respectively). A multivariable logistic regression analysis found that NASH as cause of cirrhosis and model of end-stage liver disease score are independent predictors of sarcopenic obesity after controlling for age, gender, alcoholic liver disease diagnosis, and HCC (P = 0.014 and 0.038, respectively; 95% confidence interval, 1.44-25.26 and 1.00-1.15, respectively; OR 6.03, 1.08, respectively). CONCLUSIONS Sarcopenia and sarcopenic obesity is seen in a significant number of patients with cirrhosis undergoing LT evaluation. Sarcopenia progresses after LT initially and does not recover at least within the first year after surgery. Obesity is an independent predictor of pretransplant sarcopenia and NASH was associated with 6-fold increased risk of having sarcopenic obesity in cirrhotic patients in our cohort.
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Affiliation(s)
- Sandra Carias
- Department of Surgery, Division of Transplantation, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Ana Lia Castellanos
- Department of Surgery, Division of Transplantation, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Valery Vilchez
- Department of Surgery, Division of Transplantation, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Rashmi Nair
- Department of Surgery, Division of Transplantation, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Anna Christina Dela Cruz
- Division of Digestive Diseases and Nutrition, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Jennifer Watkins
- Department of Surgery, Division of Transplantation, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Terrence Barrett
- Division of Digestive Diseases and Nutrition, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Patel Trushar
- Division of Digestive Diseases and Nutrition, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Karyn Esser
- Department of Surgery, Division of Transplantation, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Roberto Gedaly
- Department of Surgery, Division of Transplantation, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
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Buch A, Carmeli E, Boker LK, Marcus Y, Shefer G, Kis O, Berner Y, Stern N. Muscle function and fat content in relation to sarcopenia, obesity and frailty of old age--An overview. Exp Gerontol 2016; 76:25-32. [PMID: 26785313 DOI: 10.1016/j.exger.2016.01.008] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/14/2015] [Accepted: 01/14/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIM In western countries, the proportion of people over age 60 is increasing faster than any other group. This is linked to higher rates of obesity. Older age, co-morbidities and obesity are all associated with frailty syndrome. In the core of both frailty and sarcopenia there are dysfunction and deterioration of the muscle and the fat tissues. This overview interlinks the phenotypes presented in older adults such as sarcopenia and frailty-alone and with relation to obesity, muscle function and fat tissue accumulation. RECENT FINDINGS Observational studies have well described the loss of muscle mass and strength through the years of adult life, both components of frailty and sarcopenia. They have shown that these changes are associated with dysmetabolism and functional deterioration, independent of common explanatory variables. In the metabolic mechanism core of this link, insulin resistance and higher ectopic fat accumulation may play a role. Basic experiments have partially validated this hypothesis. Whether there is a synergistic effect of obesity and frailty phenotype on morbidity risk is still questionable and currently under investigation; however, few cohort studies have shown that the frail-obese or sarcopenic-obese group have higher probability for metabolic complications. SUMMARY Muscle mass loss and fat accumulation in the muscle in the elderly, with or without the presence of obesity, may explain some of the functional and metabolic defects shown in the frail, sarcopenic population.
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Affiliation(s)
- Assaf Buch
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Israel.
| | - Eli Carmeli
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; School of Public Health, Haifa University, Haifa, Israel
| | | | - Yonit Marcus
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Gabi Shefer
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Ofer Kis
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Yitshal Berner
- The Sackler Faculty of Medicine, Tel-Aviv University, Israel; Meir Medical Center, Kfar Saba, Israel
| | - Naftali Stern
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Poggiogalle E, Lubrano C, Sergi G, Coin A, Gnessi L, Mariani S, Lenzi A, Donini LM. Sarcopenic Obesity and Metabolic Syndrome in Adult Caucasian Subjects. J Nutr Health Aging 2016; 20:958-963. [PMID: 27791227 DOI: 10.1007/s12603-015-0638-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Recently metabolic aspects linked to sarcopenic obesity (SO) were investigated. Extant studies involved especially older people from Asian or White-mixed American cohorts. THE AIMS OF OUR STUDY WERE to explore the prevalence of sarcopenia in Caucasian adult obese subjects using two different indices of sarcopenia, and to investigate the relationship among SO, metabolic syndrome (MS), inflammation, and serum albumin concentrations. DESIGN Cross- sectional study. SUBJECTS/METHODS The study was performed from 2011 to 2014 in a hospitalized care setting. Inclusion criteria were: age>18 and <65 years, BMI≥30 Kg/m2. Fat mass (FM) and fat-free mass (FFM) were assessed by DXA. Appendicular skeletal muscle mass (ASMM) was calculated. Sarcopenia was defined as ASMM/height2 or ASMM/weight <2SD than the sex-specific mean of a young population. The cutoffs were ASMM/h2<6.54 Kg/m2 for men and 4.82 Kg/m2 for women, and ASMM/weight<0.2827 for men and 0.2347 for women. ISI-Matsuda was calculated. MS was diagnosed (NCEP-ATPIII). RESULTS 727 subjects (age: 45.72±13.56 years, BMI: 37.74±5.82 kg/m2) were enrolled. The prevalence of SO was 1.0% or 34.8% in men and 0.6% or 50.1% in women, using ASMM/height2 ratio or ASMM/weight. Subjects with SO based on ASMM/height2 were scarce, only data relying on ASMM/weight were considered. Subjects with SO had higher BMI, waist circumference, FM, and lower FFM and ASMM than nonsarcopenic obese individuals (all p<0.05). ISI-Matsuda was lower and hs-CRP levels were higher in subjects with SO (all p<0.05). MS was more prevalent in subjects with SO than nonsarcopenic obese subjects (47.6% vs 34.3%, p<0.001). ASMM/weight was decreased in subjects with MS (0.2522±0.0410 vs 0.2423±0.0352, p=0.001). CONCLUSION SO is associated with MS and low- grade inflammation in adult Caucasian subjects. Metabolic profile evaluation should be recommended in subjects with SO.
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Affiliation(s)
- E Poggiogalle
- Dr Eleonora Poggiogalle, MD, "Sapienza" University of Rome, Department of Experimental Medicine, Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Piazzale Aldo Moro, 5- 00185 Rome, Italy, phone: +39 064991 0996, fax: +39 06 4991 0699, email address:
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Moon JH, Moon JH, Kim KM, Choi SH, Lim S, Park KS, Kim KW, Jang HC. Sarcopenia as a Predictor of Future Cognitive Impairment in Older Adults. J Nutr Health Aging 2016; 20:496-502. [PMID: 27102786 DOI: 10.1007/s12603-015-0613-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We investigated the association between the indices of sarcopenia and future risk of cognitive impairment in older adults. DESIGN Community-based prospective cohort study. SETTING Community. PARTICIPANTS A total of 297 participants aged ≥65 years without cognitive impairment at baseline (mean age, 71.9 ± 6.6 years; men:women, 158:139) and who underwent cognitive evaluation at the 5-year follow-up. MEASUREMENTS Sarcopenia parameters including appendicular lean mass (ALM), handgrip strength, and the Short Physical Performance Battery (SPPB) score at baseline were compared according to the later progression of mild cognitive impairment (MCI) and/or dementia. The operational criteria suggested by the Foundation for the National Institutes of Health Sarcopenia Project were used. We performed multivariate logistic regression analysis to identify the independent indicators of the progression of cognitive impairment. RESULTS Among the 297 participants, 242 (81.5%) remained cognitively normal (nonprogression group), whereas 55 (18.5%) showed progression of cognitive impairment (50 subjects (16.8%) to MCI and 5 subjects (1.7%) to dementia) (progression group). Compared with the nonprogression group, subjects in the progression group were older, had a lower educational level, and had lower physical function as assessed by the SPPB; a higher percentage were depressed. Other baseline markers of sarcopenia, including the ALM-to-body mass index ratio and handgrip strength did not differ significantly between the groups. The association between a low SPPB score (<9) and progression of cognitive impairment was maintained after adjustment for conventional risk factors for cognitive impairment (hazard ratio 2.222, 95% confidence interval 1.047-4.716, P = 0.038). CONCLUSION Decreased physical performance, as assessed by the SPPB, but not other markers of sarcopenia, was independently associated with the risk of later cognitive impairment in older adults.
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Affiliation(s)
- J H Moon
- Hak Chul Jang, MD, PhD, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea, Tel: +82-31-787-7005, Fax: +82-31-787-4051, E-mail:
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Papachristou E, Ramsay SE, Lennon LT, Papacosta O, Iliffe S, Whincup PH, Wannamethee SG. The relationships between body composition characteristics and cognitive functioning in a population-based sample of older British men. BMC Geriatr 2015; 15:172. [PMID: 26692280 PMCID: PMC4687114 DOI: 10.1186/s12877-015-0169-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/11/2015] [Indexed: 12/16/2022] Open
Abstract
Background Current research has established obesity as one of the main modifiable risk factors for cognitive impairment. However, evidence on the relationships of total and regional body composition measures as well as sarcopenia with cognitive functioning in the older population remains inconsistent. Methods Data are based on 1,570 participants from the British Regional Heart Study (BRHS), a cohort of older British men from 24 British towns initiated in 1978–80, who were re-examined in 2010–12, aged 71–92 years. Cognitive functioning was assessed with the Test-Your-Memory cognitive screening tool. Body composition characteristics assessed using bioelectrical impedance analysis included total fat mass (FM), central FM, peripheral FM, and visceral fat level. Sarcopenia was defined using the European Working Group on Sarcopenia in Older People (EWGSOP) definition of severe sarcopenia and the Foundation for the National Institutes of Health (FNIH) sarcopenia project criteria. Results Among 1,570 men, 636 (41 %) were classified in the mild cognitive impairment (MCI) and 133 (8 %) in the severe cognitive impairment (SCI) groups. Age-adjusted multinomial logistic regressions showed that compared with participants in the normal cognitive ageing group, those with SCI were more likely to have waist circumference >102 cm, BMI >30 kg/m2, to be in the upper quintile of total FM, central FM, peripheral FM and visceral fat level and to be sarcopenic. The relationships remained significant for total FM (RR = 2.16, 95 % CI 1.29–3.63), central FM (RR = 1.85, 95 % CI 1.09–3.14), peripheral FM (RR = 2.67, 95 % CI 1.59–4.48), visceral fat level (RR = 2.28, 95 % CI 1.32–3.94), BMI (RR = 2.25, 95 % CI 1.36–3.72) and waist circumference (RR = 1.63, 95 % CI 1.05–2.55) after adjustments for alcohol, smoking, social class, physical activity and history of cardiovascular diseases or diabetes. After further adjustments for interleukin-6 and insulin resistance, central FM, waist circumference and sarcopenia were no longer significantly associated with SCI. Conclusions Increased levels of peripheral FM, visceral fat level, and BMI are associated with SCI among older people. Distinct pathophysiological mechanisms link regional adipose tissue deposition and cognitive functioning.
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Affiliation(s)
- Efstathios Papachristou
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
| | - Sheena E Ramsay
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Lucy T Lennon
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Olia Papacosta
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Steve Iliffe
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - S Goya Wannamethee
- Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
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Cho Y, Shin SY, Shin MJ. Sarcopenic obesity is associated with lower indicators of psychological health and quality of life in Koreans. Nutr Res 2015; 35:384-92. [DOI: 10.1016/j.nutres.2015.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 03/24/2015] [Accepted: 04/06/2015] [Indexed: 12/31/2022]
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Sohrabi HR, Bates KA, Weinborn M, Bucks RS, Rainey-Smith SR, Rodrigues MA, Bird SM, Brown BM, Beilby J, Howard M, Criddle A, Wraith M, Taddei K, Martins G, Paton A, Shah T, Dhaliwal SS, Mehta PD, Foster JK, Martins IJ, Lautenschlager NT, Mastaglia F, Laws SM, Martins RN. Bone mineral density, adiposity, and cognitive functions. Front Aging Neurosci 2015; 7:16. [PMID: 25741279 PMCID: PMC4332358 DOI: 10.3389/fnagi.2015.00016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/03/2015] [Indexed: 12/12/2022] Open
Abstract
Cognitive decline and dementia due to Alzheimer's disease (AD) have been associated with genetic, lifestyle, and environmental factors. A number of potentially modifiable risk factors should be taken into account when preventive or ameliorative interventions targeting dementia and its preclinical stages are investigated. Bone mineral density (BMD) and body composition are two such potentially modifiable risk factors, and their association with cognitive decline was investigated in this study. 164 participants, aged 34–87 years old (62.78 ± 9.27), were recruited for this longitudinal study and underwent cognitive and clinical examinations at baseline and after 3 years. Blood samples were collected for apolipoprotein E (APOE) genotyping and dual energy x-ray absorptiometry (DXA) was conducted at the same day as cognitive assessment. Using hierarchical regression analysis, we found that BMD and lean body mass, as measured using DXA were significant predictors of episodic memory. Age, gender, APOE status, and premorbid IQ were controlled for. Specifically, the List A learning from California Verbal Learning Test was significantly associated with BMD and lean mass both at baseline and at follow up assessment. Our findings indicate that there is a significant association between BMD and lean body mass and episodic verbal learning. While the involvement of modifiable lifestyle factors in human cognitive function has been examined in different studies, there is a need for further research to understand the potential underlying mechanisms.
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Affiliation(s)
- Hamid R Sohrabi
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia
| | - Kristyn A Bates
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; The School of Animal Biology, University of Western Australia Crawley, WA, Australia
| | - Michael Weinborn
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychology, University of Western Australia Crawley, WA, Australia
| | - Romola S Bucks
- School of Psychology, University of Western Australia Crawley, WA, Australia
| | - Stephanie R Rainey-Smith
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Mark A Rodrigues
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Sabine M Bird
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia
| | - Belinda M Brown
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - John Beilby
- School of Pathology and Laboratory Medicine, University of Western Australia Nedlands, WA, Australia ; PathWest Laboratory Medicine of WA Nedlands, WA, Australia
| | - Matthew Howard
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Arthur Criddle
- Western Medicine, Hollywood Specialist Centre Nedlands, WA, Australia
| | - Megan Wraith
- Western Medicine, Hollywood Specialist Centre Nedlands, WA, Australia
| | - Kevin Taddei
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Georgia Martins
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Athena Paton
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Tejal Shah
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | | | - Pankaj D Mehta
- Division of Immunology, Department of Developmental Neurobiolog,Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA
| | - Jonathan K Foster
- Neurosciences Unit, Health Department of WA, School of Psychology and Speech Pathology, Curtin University of Technology Perth, WA, Australia
| | - Ian J Martins
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Nicola T Lautenschlager
- School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia ; Academic Unit for Psychiatry of Old Age, St. Vincent's Health, Department of Psychiatry, University of Melbourne Parkville, VIC, Australia ; The WA Centre for Health and Ageing, University of Western Australia Crawley, Australia
| | - Francis Mastaglia
- Institute for Immunology and Infectious Diseases, Murdoch University WA, Australia
| | - Simon M Laws
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Ralph N Martins
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia
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Lower lean mass and higher percent fat mass in patients with Alzheimer's disease. Exp Gerontol 2014; 58:30-3. [DOI: 10.1016/j.exger.2014.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Revised: 07/09/2014] [Accepted: 07/11/2014] [Indexed: 01/19/2023]
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Guichelaar MMJ, Charlton MR. Decreased muscle mass in nonalcoholic fatty liver disease: new evidence of a link between growth hormone and fatty liver disease? Hepatology 2014; 59:1668-70. [PMID: 24691865 DOI: 10.1002/hep.27058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 02/04/2014] [Indexed: 12/15/2022]
Affiliation(s)
- Maureen M J Guichelaar
- Division of Gastroenterology and Hepatology, Medical Spectrum Twente, Enschede, the Netherlands
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Ellis A, Crowe K, Lawrence J. Obesity-related inflammation: implications for older adults. J Nutr Gerontol Geriatr 2014; 32:263-90. [PMID: 24224937 DOI: 10.1080/21551197.2013.842199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The combination of age-related increases in obesity and inflammation can lead to chronic disease, decreased strength, and physical disability. Lifestyle interventions that include moderate caloric restriction along with aerobic and resistance exercise have shown improvements in metabolic outcomes, strength, and physical function in obese older adults. Although few weight loss studies have addressed diet quality, evidence summarized in this review suggests that encouraging intake of antioxidant-rich fruits and vegetables, high-quality protein, low-glycemic index carbohydrates, and omega-3 fatty acids may further ameliorate obesity-related inflammation. Future controlled trials are indicated to examine the effects of incorporating these foods into multimodal weight loss interventions.
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Affiliation(s)
- Amy Ellis
- a Department of Human Nutrition , University of Alabama , Tuscaloosa , Alabama , USA
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Donini LM, Ricciardi LM, Neri B, Lenzi A, Marchesini G. Risk of malnutrition (over and under-nutrition): validation of the JaNuS screening tool. Clin Nutr 2013; 33:1087-94. [PMID: 24373664 DOI: 10.1016/j.clnu.2013.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 12/04/2013] [Accepted: 12/05/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Malnutrition (over and under-nutrition) is highly prevalent in patients admitted to hospital and it is a well-known risk factor for increased morbidity and mortality. Nutritional problems are often misdiagnosed, and especially the coexistence of over and undernutrition is not usually recognized. We aimed to develop and validate a screening tool for the easy detection and reporting of both undernutrition and overnutrition, specifically identifying the clinical conditions where the two types of malnutrition coexist. METHODS The study consisted of three phases: 1) selection of an appropriate study population (estimation sample) and of the hospital admission parameters to identify overnutrition and undernutrition; 2) combination of selected variables to create a screening tool to assess the nutritional risk in case of undernutrition, overnutrition, or the copresence of both the conditions, to be used by non-specialist health care professionals; 3) validation of the screening tool in a different patient sample (validation sample). RESULTS Two groups of variables (12 for undernutrition, 7 for overnutrition) were identified in separate logistic models for their correlation with the outcome variables. Both models showed high efficacy, sensitivity and specificity (overnutrition, 97.7%, 99.6%, 66.6%, respectively; undernutrition, 84.4%, 83.6%, 84.8%). The logistic models were used to construct a two-faced test (named JaNuS - Just A Nutritional Screening) fitting into a two-dimension Cartesian coordinate graphic system. In the validation sample the JaNuS test confirmed its predictive value. Internal consistency and test-retest analysis provide evidence for the reliability of the test. CONCLUSION The study provides a screening tool for the assessment of the nutritional risk, based on parameters easy-to-use by health care personnel lacking nutritional competence and characterized by excellent predictive validity. The test might be confidently applied in the clinical setting to determine the importance of malnutrition (including the copresence of over and undernutrition) as a risk factor for morbidity and mortality.
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Affiliation(s)
- Lorenzo M Donini
- Department Experimental Medicine, Medical Physiopathology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, 00185 Roma, Italy.
| | - Laura Maria Ricciardi
- Department of Medicine and Surgery, Unit of Metabolic Diseases & Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Italy
| | - Barbara Neri
- Department Experimental Medicine, Medical Physiopathology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, 00185 Roma, Italy
| | - Andrea Lenzi
- Department Experimental Medicine, Medical Physiopathology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Sapienza University of Rome, 00185 Roma, Italy
| | - Giulio Marchesini
- Department of Medicine and Surgery, Unit of Metabolic Diseases & Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Italy
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Liao KC, Pu SJ, Lin CH, Chang HJ, Chen YJ, Liu MS. Association between the metabolic syndrome and its components with falls in community-dwelling older adults. Metab Syndr Relat Disord 2012; 10:447-51. [PMID: 22994428 DOI: 10.1089/met.2012.0046] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The metabolic syndrome and falls are both serious and common health problems in older adults. However, little is known about whether the metabolic syndrome contributes to falls. We investigated the relationship between the metabolic syndrome and its components with falls in community-dwelling older adults. METHODS We designed and conducted a cross-sectional study. A total of 1165 community-dwelling older adults who received a geriatric health examination, including interviewer-administered questionnaires and physical and biochemical examinations, were retrospectively enrolled from 2008 to 2010 and specifically asked about the history of falls in the preceding year. RESULTS The mean age of the participants was 74.9 ± 6.7 years, and 54.3% were women. The overall prevalence of falls and metabolic syndrome were 17.9% and 27.3%, respectively. Compared with those who did not fall, the participants who fell had a higher prevalence of the metabolic syndrome (45.7% versus 23.3%, P<0.001) and four of its five components, namely, abdominal obesity (51.2% versus 40.2 %, P=0.004), hypertriglyceridemia (32.2% versus 21.8%, P=0.001), hypertension (60.0% versus 50.0%, P=0.009), and impaired glucose tolerance (28.4 % versus 16.0%, P<0.001). After adjusting for age, female sex, the Karnofsky Performance Scale, and the five-item Brief Symptom Rating Scale, the metabolic syndrome was a significant independent risk factor for falls in community-dwelling older adults (odds ratio=2.56, 95% confidence interval 1.86-3.51). Because falling is a multifactorial geriatric syndrome, many potential confounders, such as visual abnormalities, obesity, arthritis, and polypharmacy, were not considered in this study. CONCLUSION The metabolic syndrome is an independent risk factor for falls in community-dwelling older adults and should be addressed with regard to prevention of falls.
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Affiliation(s)
- Kuo-Chen Liao
- Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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