Correlation Of Sarcopenia And Cognitive Impairment In Elderly People With White Matter Hyperintensities

Objective: To explore the relationship between sarcopenia-related indicators,cognitive impairment and cerebral white matter hyperintensities(WMHs).Methods: A total of 95 hospitalized older adults aged 60 to 85 years in the Second People’s Hospital of Hefei from 2020 to 2022 were included in this study.Three indicators related to sarcopenia were measured: hand grip strength,gait speed,and appendicular skeletal muscle mass(ASM).The diagnosis of sarcopenia was defined according to the consensus of the Asian Working Group for Sarcopenia 2019(AWGS2019).Cognitive function was assessed using the Montreal Cognitive Assessment(Mo CA)scale.WMHs levels were assessed by 3.0T superconducting magnetic resonance imaging.Results: In the analysis of participants’ clinical characteristics we found that members with cognitive impairment tended to be older,female,lighter in weight,and with lower BMI(P<0.05).All three indices of sarcopenia were significantly negatively associated with WMHs class in both men and women,except for ASM and WMHs class in women(P<0.01).Even after adjusting for possible confounders,the three indices associated with sarcopenia remained significantly associated with WMHs in females(grip strength:OR=0.736,95%CI=0.579-0.937,P=0.013;gait speed: OR=0.005,95%CI=0.0001-0.224,P=0.006;ASM: OR=0.007,95%CI=0.0002-0.206,P=0.004),whereas grip strength and ASM were significantly associated with WMHs in males(grip strength: OR=0.787,95%CI=0.681-0.908,P=0.001;ASM: OR=0.187,95%CI=0.057-0.614,P=0.006).Scores on the Mo CA scale were significantly positively associated with grip strength(men: r=0.534,P<0.001;women: r=0.332,P=0.023)、 gait speed(men: r=0.537,P<0.001;women: r=0.399,P=0.005)and ASM(men: r=0.524,P=P<0.001;women: r=0.418,P=0.003)in both males and females.After adjusting for confounders and WMHs,the regression analysis revealed an increased prevalence of cognitive impairment in patients with the presence of sarcopenia relative to patients without sarcopenia(OR=31.59,95%CI=5.87-170.11,P<0.001).In male patients,the risk of developing cognitive impairment increased with increasing brain white matter grade,and this relationship persisted even after adjusting for confounding factors.Conclusion: In summary,we explored the complex relationship between sarcopenia and its related indicators,cognitive impairment,and WMHs in hospitalized older adults and found that sarcopenia and its three related indicators,grip strength,gait speed,and ASM,were significantly related to cognitive impairment in patients with WMHs.Both the indicators of sarcopenia and the severity of cognitive impairment were influenced by the severity of WMHs.WMHs may be one of the factors linking myasthenia gravis and cognitive function.