Abstract
BackgroundSarcopenia has been identified as a risk factor for cognitive impairment, and motoric cognitive risk syndrome (MCR) is a recently defined pre-dementia syndrome. It is not known whether they are related. We aimed to investigate the association and potential pathways between sarcopenia and MCR in the community elderly by establishing a moderated mediation model.Methods846 community residents aged ≥ 60 years were recruited from May 2021 to September 2021 and had a comprehensive geriatric evaluation. The diagnosis of sarcopenia followed the criteria issued by the Asian Working Group for Sarcopenia in 2019. MCR was defined as subjective cognitive decline and slow gait. Apathy symptoms and physical activity were assessed by the Apathy Evaluation Scale (AES) and the International Physical Activity Questionnaire (IPAQ). Logistic regression and moderated mediation analyses were conducted to explore the association between the four.Results60 (7.1%) had MCR among 846 participants. After full adjustment, sarcopenia (odds ratio [OR] = 3.81, 95% confidence interval [CI] = 1.69–8.60, P = 0.001), AES score (OR = 1.09, 95% CI = 1.04–1.14, P < 0.001), and IPAQ level (OR = 0.43, 95% CI = 0.28–0.66, P < 0.001) were associated with MCR. Apathy partially mediated the relationship between sarcopenia and MCR. Physical activity played a moderation role in the indirect pathway of the mediation model. The increase in physical activity can alleviate the indirect effect of sarcopenia on MCR.ConclusionWe established a moderated mediation model to uncover the underlying association mechanism of sarcopenia and MCR preliminarily. These findings suggest that attention should be paid to the management of apathy and physical activity in the context of sarcopenia to prevent early dementia actively. Further validation is needed in future longitudinal studies.
Highlights
Motoric cognitive risk syndrome (MCR) was proposed and verified in 2013, defined as cognitive complaints and slow gait in the elderly without dementia and mobility disability [1]
In health-related variables, night sleep duration, number of prescription drugs, number of chronic diseases, chronic respiratory diseases, arthritis, Mini Nutritional Assessment Short-Form (MNA-SF), International Physical Activity Questionnaire (IPAQ), fall history last year, poor self-perceived vision, poor self-perceived health, Geriatric Depression Scale (GDS) score, Apathy Evaluation Scale (AES) score, mini-mental state examination (MMSE) score, sarcopenia, skeletal muscle index (SMI), handgrip strength, five-times sit-to-stand test (FTSST) time and gait speed were significantly different between groups (P < 0.05)
Associations of sarcopenia, apathy, and physical activity with motoric cognitive risk syndrome (MCR) Sarcopenia, apathy, and physical activity were associated with MCR both in univariate and multivariate logistic regression models (Table 3)
Summary
Motoric cognitive risk syndrome (MCR) was proposed and verified in 2013, defined as cognitive complaints and slow gait in the elderly without dementia and mobility disability [1]. Recent studies have shown that, except for influence on physical function, sarcopenia is related to cognitive impairment in the elderly [8, 9]. Diagnostic components of sarcopenia (muscle mass [11, 12], muscle strength [13], and physical function [13, 14]) were independently associated with cognitive impairment to varying degrees. Sarcopenia has been identified as a risk factor for cognitive impairment, and motoric cognitive risk syndrome (MCR) is a recently defined pre-dementia syndrome. It is not known whether they are related. We aimed to investigate the association and potential pathways between sarcopenia and MCR in the community elderly by establishing a moderated mediation model
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