Clinical Sciences/Health Conditions
Nan Chen, PhD
Prof.
Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine: Shanghai Jiaotong University School of Medicine Xinhua Hospital
shanghai, Shanghai, China (People's Republic)
Sarcopenic obesity (SO), defined as the coexistence of sarcopenia and obesity, is increasingly recognized in aging populations. Cognitive impairment is another common age-related condition. However, their epidemiological relationship remains unclear. This study examined the association between SO and cognitive performance using data from the National Health and Nutrition Examination Survey (NHANES).
Design:
A cross-sectional analysis was conducted among adults aged ≥60 years from the 1999–2002 NHANES cycles. SO was defined using Foundation for the National Institutes of Health (FNIH) criteria based on sex-specific lean mass thresholds (men: 0.789; women: 0.512) and waist circumference (men >108 cm; women >88 cm). Cognitive function was assessed using the Digit Symbol Substitution Test (DSST), reflecting processing speed, attention, and working memory. Multivariable linear regression models were used to evaluate the association between SO and DSST scores with sequential adjustment for demographic, socioeconomic, and lifestyle factors.
Results:
A total of 2,348 eligible participants were included (mean age 70.8 ± 7.65 years; 50.6% women). Individuals with SO were more likely to be women or Mexican American, have lower education and household income, and exhibit higher prevalence of metabolic and cardiovascular diseases. In the unadjusted model, SO was significantly associated with lower DSST scores (β = −5.1, p = 0.048). This association remained after adjusting for age, sex, and race/ethnicity (β = −4.8, p = 0.025), but attenuated and became non-significant after further adjustment for socioeconomic factors (education, PIR, marital status) (β = −1.4, p = 0.40).
Conclusion:
Sarcopenic obesity shows an initial association with poorer cognitive performance; however, this relationship may be substantially influenced by socioeconomic confounders. Longitudinal studies are warranted to clarify the independent effect of SO on cognitive decline and to explore whether integrated interventions targeting SO may offer cognitive health benefits.
