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The journal of nutrition, health & aging

, Volume 23, Issue 1, pp 35–41 | Cite as

Associations of Skeletal Muscle Mass, Lower-Extremity Functioning, and Cognitive Impairment in Community-Dwelling Older People in Japan

  • Hideaki IshiiEmail author
  • H. Makizako
  • T. Doi
  • K. Tsutsumimoto
  • H. Shimada
Article

Abstract

Objective

We examined whether skeletal muscle mass and lower extremity functioning are closely associated with multiple cognitive domains, including global cognition, memory, attention, executive functioning, and processing speed, in community-dwelling older Japanese adults.

Design

A cross-sectional, population-based community study.

Setting

This study was conducted among community-living older people enrolled in the Obu Study of Health Promotion for the Elderly.

Participants

Participants comprised 5,104 adults (≥ 65 years, mean age: 71 years).

Measurements

Data from 4273 participants were analyzed. Appendicular skeletal muscle mass was estimated from bioelectrical impedance analysis and expressed as appendicular skeletal muscle mass index (ASMI). Lower-extremity functioning was assessed by the Five-Times-Sit-to-Stand test (FTSS) and Timed Up and Go test (TUG). Cognitive functions were assessed by the Mini Mental State Examination, word list memory, Trail Making Test parts A and B, and Symbol Digit Substitution Task. Logistic regression analysis were performed to calculate odds ratios (ORs) of cognitive impairment in various domains among skeletal muscle mass, lower-extremity functioning levels adjusted for important demographic variables, and comorbidities.

Results

Participants with lower ASMI and slower FTSS and TUG groups had lower cognitive functioning scores than did participants with higher ASMI and faster FTSS and TUG. The slowest quartiles (Q4) of FTSS and TUG were significantly associated with impaired global functioning (MMSE score < 24) compared to the fastest quartile (Q1) after multivariate adjustment (FTSS, OR = 1.46, 95% confidence interval (CI) = 1.12–1.90; TUG, OR = 1.65, 95% CI = 1.25–2.17). In other dimensions of cognitive functioning, FTSS and TUG were significantly associated with all cognitive impairment in the full adjustment model.

Conclusion

Lower-extremity functioning, rather than skeletal muscle mass, is closely related to multiple cognitive domains. This study suggests that maintaining lower-extremity functioning, rather than skeletal muscle mass, may be required for detecting and preventing cognitive impairment.

Key words

Cognition lower-extremity functioning mobility weakness community-dwelling older people 

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Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Hideaki Ishii
    • 1
    • 4
    Email author
  • H. Makizako
    • 1
    • 2
  • T. Doi
    • 1
  • K. Tsutsumimoto
    • 1
    • 3
  • H. Shimada
    • 1
  1. 1.Department of Preventive Gerontology, Center for Gerontology and Social ScienceNational Center for Geriatrics and GerontologyObu, AichiJapan
  2. 2.Department of Physical Therapy, School of Health Sciences, Faculty of MedicineKagoshima UniversityKagoshimaJapan
  3. 3.Japan Society for the Promotion of ScienceTokyoJapan
  4. 4.Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social ScienceNational Center for Geriatrics and GerontologyObu City, Aichi PrefectureJapan

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