One-year change in sarcopenia was associated with cognitive impairment among haemodialysis patients

IF 8.9 1区医学 Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2023-08-09 DOI:10.1002/jcsm.13311

Yuqi Yang, Jingjing Da, Jing Yuan, Yan Zha

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引用次数: 1

Abstract

Background

Our study aimed to evaluate change in sarcopenia, its defining components over 1 year follow-up and investigate associations with subsequent cognitive decline, incident mild cognitive impairment (MCI) and dementia among patients undergoing haemodialysis (HD).

Methods

In the multicentre, longitudinal study, 1117 HD patients aged 56.8 ± 14.3 years (654 men; and 463 women) from 17 dialysis centres in Guizhou Province, China, were recruited in 2019 and followed up for 1 year in 2020. Sarcopenia was diagnosed with Asian Working Group for Sarcopenia criteria using appendicular skeletal muscle mass index (ASMI) and handgrip strength (HGS). Body composition was measured using body composition monitor; body water, weight, and height were corrected to calculate ASMI. HGS was measured by mechanical handgrip dynamometer. Cognitive function was measured with Mini Mental State Examination. Multivariate linear, logistic regression models and subgroup analyses were employed to examine the associations of changes in sarcopenia, ASMI, and HGS with Mini Mental State Examination score change, and incident MCI, dementia.

Results

Four hundred fourteen (37.1%) patients had sarcopenia at baseline; during 1 year follow-up, 257 (23.0%) developed MCI and 143 (12.8%) developed dementia. According to changes in sarcopenia, patients were stratified into four groups: non-sarcopenia; non-sarcopenia to sarcopenia; sarcopenia; and sarcopenia to non-sarcopenia. HD patients in sarcopenia and non-sarcopenia to sarcopenia groups had higher risk of MCI (34.8%, 32.0%, vs. 17.4%) and dementia (20.6%, 19.8%, vs. 8.7%), compared non-sarcopenia group (P < 0.001). Multivariate linear regression analyses showed that sarcopenia [regression coefficients (β) −1.098, 95% confidence interval (CI) −1.872, −0.324, P = 0.005] and non-sarcopenia to sarcopenia (β −1.826, −2.441, −1.212, P < 0.001) were associated with faster cognitive decline compared to non-sarcopenia. HGS decline (β 0.046, 0.027–0.064, P < 0.001) and ASMI decline (β 0.236, 0.109–0.362, P < 0.001) were both positively associated with cognitive decline. Multivariate logistic regression analyses demonstrated that patients with sarcopenia and non-sarcopenia to sarcopenia were both at increased risk of developing MCI [odds ratio (OR) 1.788, 95% CI 1.115–2.870, P = 0.016 and OR 1.589, 95% CI 1.087–2.324, P = 0.017, respectively], but only non-sarcopenia to sarcopenia was at increased risk of dementia (OR 1.792, 95% CI 1.108–2.879, P = 0.017). Both greater change of ASMI and HGS had lower risk of MCI with adjusted ORs of 0.857 (0.778–0.945, P = 0.002) and 0.976 (0.963–0.989, P < 0.001). Robust associations were found among female individuals, aged >60 years, and with low educational level.

Conclusions

Longitudinal associations were observed between new-onset, persistent sarcopenia, and cognitive impairment. Early detection and intervention should be implemented to delay the onset of sarcopenia and improve cognitive health among HD patients.

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血液透析患者少肌症一年的变化与认知障碍有关。

背景：我们的研究旨在评估在接受血液透析（HD）的患者中少肌症的变化及其定义成分，并调查其与随后的认知能力下降、轻度认知障碍（MCI）和痴呆的关系。方法：在多中心纵向研究中，2019年招募了来自中国贵州省17个透析中心的1117名HD患者，年龄为56.8±14.3岁（654名男性；463名女性），并于2020年随访了1年。Sarcopenia是根据亚洲Sarcoponia工作组的标准，使用阑尾骨骼肌质量指数（ASMI）和握力（HGS）诊断的。使用身体成分监测器测量身体成分；校正身体水分、体重和身高以计算ASMI。HGS采用机械握力测功机测量。认知功能采用迷你精神状态检查法进行测量。采用多变量线性、逻辑回归模型和亚组分析来检查少肌症、ASMI和HGS的变化与迷你精神状态检查分数变化以及MCI、痴呆事件的相关性。结果：414例（37.1%）患者在基线时出现少肌症；在一年的随访中，257人（23.0%）出现MCI，143人（12.8%）出现痴呆。根据少肌症的变化，将患者分为四组：非少肌症；非少肌症至少肌症；少肌症；以及少肌症至非少肌症。少肌症和非少肌症至少肌症组的HD患者患MCI（34.8%，32.0%，vs.17.4%）和痴呆（20.6%，19.8%，vs.8.7%）的风险更高，结论：HD患者新发、持续性少肌症和认知障碍之间存在纵向相关性，应及早发现和干预，以延缓少肌症的发作，改善认知健康。

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来源期刊

Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine

自引率

12.40%

发文量

期刊介绍： The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.