The mediating effect of arteriosclerosis on the relationship between sarcopenia and cognitive impairment: a...

Sarcopenia and arteriosclerosis are important factors affecting cognitive function, but their interrelationships remain unclear. This study investigated whether arteriosclerosis mediates the mediation effect between sarcopenia and cognitive impairment.

A total of 105 patients aged ≥ 60 years from geriatric clinics were enrolled. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia criteria. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and arterial stiffness was evaluated by brachial-ankle pulse wave velocity (baPWV). Multivariate linear regression was used to analyze associations, and mediation effects were tested with the bootstrap method.

99 patients met the inclusion criteria, among whom 34 had cognitive impairment. This group showed a higher prevalence of sarcopenia and significantly elevated baPWV. Regression analyses revealed negative associations between baPWV and MMSE (β = -0.004, P < 0.001), skeletal muscle mass index (SMI) (β = -201.239, P < 0.001), and grip strength (β = -13.732, P = 0.025). MMSE was positively associated with SMI (β = 1.267, P = 0.040) and grip strength (β = 0.260, P < 0.001). Mediation analysis indicated that baPWV partially mediated the associations of grip strength (13.9%) and SMI (31.8%) with MMSE, but these effects lost significance after adjustment for confounders.

Sarcopenia is significantly associated with cognitive impairment and increased arteriosclerosis in elderly individuals. Although arteriosclerosis may be involved in this relationship, its mediating role is not robust after adjustment for confounding factors and remains inconclusive. Further longitudinal studies are required to clarify the underlying mechanisms.