# Association of Components of Severe Sarcopenia With Cognitive Decline in Older Adults: A Cross-Sectional Study

## TL;DR

This study finds that gait speed and handgrip strength are better indicators of cognitive decline than muscle mass in older adults with severe sarcopenia.

## Contribution

The study identifies gait speed and handgrip strength as stronger predictors of cognitive decline in severe sarcopenia compared to muscle mass.

## Key findings

- Gait speed (6MWT) was the strongest predictor of cognitive decline (β = 0.78, p < 0.001).
- Handgrip strength (HGS) was also a strong predictor (β = 0.40, p = 0.002).
- Muscle mass (ASM) was the weakest predictor of cognitive decline (β = 0.25, p = 0.034).

## Abstract

Background

Among the components of sarcopenia, muscle strength and gait speed are strongly associated with cognitive performance, while the role of muscle mass remains unclear, particularly in severe sarcopenia. This study aimed to investigate the association of appendicular skeletal muscle mass (ASM), handgrip strength (HGS), and gait speed (six-meter walk test, 6MWT) with the Hindi version of the Mini-Mental State Examination (HMSE) in older adults with severe sarcopenia.

Methodology

In this hospital-based, cross-sectional study, 40 adults aged ≥60 years with HMSE scores ≤23 and severe sarcopenia (Asian Working Group for Sarcopenia criteria) were enrolled. Cognitive function was assessed using HMSE. ASM was measured by bioelectrical impedance analysis, HGS with a dynamometer, and gait speed using the 6MWT. The association between components of sarcopenia and HMSE scores was evaluated using Pearson’s correlation and multiple regression analyses.

Results

The mean age of the patients was 67.5 ± 3.39 years, with 70% being males (n = 28). Common comorbidities included hypertension (70%) and diabetes mellitus (50%). The mean HMSE score was 17.8 ± 1.98. ASM (r = 0.33, p = 0.032) and 6MWT (r = 0.51, p < 0.001) positively correlated with HMSE, whereas HGS showed a positive trend (r = 0.28, p = 0.07). In multivariate regression (adjusted), gait speed (β = 0.78, p < 0.001) and HGS (β = 0.40, p = 0.002) were strong predictors of HMSE, while ASM was the weakest predictor (β = 0.25, p = 0.034). Type 2 diabetes mellitus, hypothyroidism, and chronic kidney disease were significant negative predictors.

Conclusions

In severely sarcopenic older adults, gait speed and HGS are stronger predictors of cognitive decline than muscle mass. Simple assessments of gait and handgrip may help early detection of cognitive decline.