Imaging Biomarkers of Cognitive Impairment in Sarcopenia: A Narrative Review

Sarcopenia is characterized by progressive declines in muscle strength, mass, and physical function. Mild cognitive impairment (MCI), also referred to as mild neurocognitive disorder (mNCD), involves a measurable reduction in cognitive abilities that does not substantially interfere with daily independence, thereby distinguishing it from dementia. With global population aging, both conditions have emerged as prevalent health concerns, and understanding cognitive status among individuals with sarcopenia has become increasingly important. This narrative review synthesizes current neuroimaging findings related to cognitive impairment in sarcopenia, examining both the mechanistic underpinnings and clinical relevance of this association. Particular emphasis is placed on the Muscle-Brain Axis, which provides a foundational framework for understanding how imaging biomarkers may bridge sarcopenia and cognitive decline. Within the imaging domain, this article focuses on Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET), reviewing their applications in detecting and characterizing cognitive impairment among patients with sarcopenia.