E-Poster Presentation ESA-SRB-ANZBMS 2021

Cognitive ability should be considered when assessing skeletal muscle strength and performance (#756)

Julie A Pasco 1 2 , Sophia X Sui 1 , Emma C West 1 , Kara L Holloway-Kew 1 , Kara B Anderson 1 , Amanda L Stuart 1 , Bianca E Kavanagh 1 , Kayla B Corney 1 , Lana J Williams 1
  1. Deakin University, IMPACT-Institute for Mental and Physical Health and Clinical Translation, Geelong, VICTORIA, Australia
  2. Department of Medicine-Western Health, University of Melbourne, St Albans, VICTORIA, Australia

Aim: Assessment of muscle strength and performance require input from the person being measured. None of the recent operational definitions for sarcopenia that involve these assessments has considered the person’s cognitive ability. We aimed to compare the muscle function components of the revised European Working Group on Sarcopenia in Older People (EWGSOP2), the Foundation for the National Institutes of Health (FNIH) and the Sarcopenia Definition and Outcomes Consortium (SDOC) algorithms for individuals with and without low-cognition.

Methods: This cross-sectional study involved 327 men (60-96yr). Global cognition was assessed using the Mini Mental State Examination (MMSE); MMSE scores <27 were considered as low-cognition. Handgrip strength (HGS) was measured by dynamometry and muscle performance by Timed Up-&-Go (TUG). Height and weight were measured and body mass index (BMI) calculated (kg/m2). Chi-squared test (employing Fisher’s exact test if expected cell count <5) identified differences in proportions and logistic regression models identified poor muscle function in association with low-cognition.

Results: Fifty-four (16.5%) men had low-cognition. The proportions of men with low-HGS were greater for those with vs without low-cognition according to different criteria: EWGSOP2 (9.3% vs 0.7%, p=0.002), FNIH (7.4% vs 0.7%, p=0.008) and SDOC (52.4% vs 38.1%, p=0.008); and low-HGS/BMI (18.5% vs 5.5%, p=0.003). Slow-TUG followed the same pattern (11.1% vs 1.1%, p<0.001). In models adjusted for age, men with low-cognition were 3-7 fold more likely to have low-HGS by EWGSOP2 (OR 6.66, 95%CI 1.18-37.8, p=0.03), FNIH (OR 5.71, 95%CI 0.93-35.0, p=0.06) and low-HGS/BMI (OR 3.01, 95%CI 1.19-7.63, p=0.02); and 6-fold more likely to have a slow-TUG (OR 5.82, 95%CI 1.31-25.8, p=0.02). The association between low-cognition and low-HGS by SDOC criteria was explained by age (OR 1.30, 95%CI 0.68-2.49, p=0.4).

Conclusion: Operational definitions for sarcopenia should consider low cognitive ability, at least in men, at the time muscle strength and performance are evaluated.