S..LOW1, S.F.ANG1, A.M.C.MOH1, K.ANG1, W.E.TANG2, Z.LIM3, T.SUBRAMANIAM4, C.F.SUM4, S.C.LIM4
Khoo Teck Puat Hospital1, National Healthcare Group HQ2, NHG Polyclinics3, Admiralty Medical Centre4
Sarcopenia and cognitive impairment have shared pathophysiological pathways such as inflammation and insulin resistance. However, results on the association between sarcopenia and cognitive impairment have been divergent. It is unknown if decline in skeletal muscle mass is associated with cognitive deterioration longitudinally.
This was a prospective cohort of 453 patients from SMART2D cohort over a period of 6.4years. Skeletal muscle mass was measured with bio-impedance analysis. Skeletal muscle mass index(SMI) was defined as (total skeletal muscle mass/weight)x100. Cognition was assessed with the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS). The rate of change of SMI and RBANS scores per year were computed. Multiple linear regression was performed, adjusting for demographics, education, depression, clinical parameters and presence of APOE ε4 allele.
The participants’ mean age was 60.3 ± 7.4 years. The mean RBANS total score decreased with greater SMI decline per year (i.e. decreasing tertiles) in unadjusted analysis (ptrend=0.013). Compared to patients with Tertile 3 SMI change, the group with greater SMI decline (i.e. Tertile 1 SMI change) experience 0.32 lower RBANS total score(95%CI -0.58 to -0.04; p=0.023) in fully adjusted analysis. The group with Tertile 1 SMI change also had lower RBANS total score in immediate memory(coefficient -0.56; 95%CI -1.03 to -0.08; p=0.021), visuo-spatial constructional ability(coefficient -0.70; 95%CI -1.29 to -0.11; p=0.020) and delayed memory(coefficient -0.49; 95%CI -0.98 to -0.01; p=0.047).
Skeletal muscle mass decline was consistently associated with cognitive decline. It is a potential intervention target for prevention of cognitive impairment in future clinical practice.