The prevalence of cognitive impairment in patients with sarcopenia: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

HUANG Jiahui , LUO Qiangqiang , LI Min ,  LI Jing

School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100144, P. R. China;

Corresponding author：

LI Jing, Email: lijing@nursing.pumc.edu.cn

Keywords：

Sarcopenia; Cognitive impairment; Dementia; Prevalence; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202303157

Video：

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Objective To systematically review the prevalence of cognitive impairment in patients with sarcopenia. Methods The PubMed, EMbase, Web of Science, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect studies related to the objectives from inception to December 10, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 14.0 software. Results A total of 27 studies were included. The overall prevalence rate of cognitive impairment in sarcopenia was 36.1% (95%CI 29.4% to 42.8%). Subgroup analysis showed that the prevalence in Europe was higher than that in other areas. The prevalence of nursing home residents was highest. Conclusion Current evidence shows that the prevalence of cognitive impairment in patients with sarcopenia is high. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： HUANG Jiahui, LUO Qiangqiang, LI Min, LI Jing. The prevalence of cognitive impairment in patients with sarcopenia: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2023, 23(9): 1039-1045. doi: 10.7507/1672-2531.202303157 Copy

1.	Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc, 2020, 21(3): 300-307.
2.	Vellas B, Fielding RA, Bens C, et al. Implications of ICD-10 for sarcopenia clinical practice and clinical trials: report by the international conference on frailty and sarcopenia research task force. J Frailty Aging, 2018, 7(1): 2-9.
3.	Malmstrom TK, Miller DK, Simonsick EM, et al. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle, 2016, 7(1): 28-36.
4.	Bischoff-Ferrari HA, Orav JE, Kanis JA, et al. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int, 2015, 26(12): 2793-2802.
5.	Schaap LA, van Schoor NM, Lips P, et al. Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures: the longitudinal aging study amsterdam. J Gerontol A Biol Sci Med Sci, 2018, 73(9): 1199-1204.
6.	Beaudart C, Biver E, Reginster JY, et al. Validation of the SarQoL®, a specific health-related quality of life questionnaire for Sarcopenia. J Cachexia Sarcopenia Muscle, 2017, 8(2): 238-244.
7.	De Buyser SL, Petrovic M, Taes YE, et al. Validation of the FNIH sarcopenia criteria and SOF frailty index as predictors of long-term mortality in ambulatory older men. Age Ageing, 2016, 45(5): 602-608.
8.	Petermann-Rocha F, Balntzi V, Gray SR, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle, 2022, 13(1): 86-99.
9.	McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the national institute on aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement, 2011, 7(3): 263-269.
10.	Dubois B, Villain N, Frisoni GB, et al. Clinical diagnosis of Alzheimer's disease: recommendations of the International Working Group. Lancet Neurol, 2021, 20(6): 484-496.
11.	Jia J, Wei C, Chen S, et al. The cost of Alzheimer's disease in China and re-estimation of costs worldwide. Alzheimers Dement, 2018, 14(4): 483-491.
12.	Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet, 2019, 393(10191): 2636-2646.
13.	Dhillon RJ, Hasni S. Pathogenesis and management of sarcopenia. Clin Geriatr Med, 2017, 33(1): 17-26.
14.	Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA, 2014, 312(23): 2551-2561.
15.	Bai A, Xu W, Sun J, et al. Associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old. BMC Geriatr, 2021, 21(1): 292.
16.	Beeri MS, Leugrans SE, Delbono O, et al. Sarcopenia is associated with incident Alzheimer's dementia, mild cognitive impairment, and cognitive decline. J Am Geriatr Soc, 2021, 69(7): 1826-1835.
17.	Peng TC, Chen WL, Wu LW, et al. Sarcopenia and cognitive impairment: a systematic review and meta-analysis. Clin Nutr, 2020, 39(9): 2695-2701.
18.	Jacob L, Kostev K, Smith L, et al. Sarcopenia and mild cognitive impairment in older adults from six low- and middle-income countries. J Alzheimers Dis, 2021, 82(4): 1745-1754.
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25.	张栌尹, 莫永珍, 欧阳晓俊, 等. 住院老年患者肌少症患病率及相关因素分析. 老年医学与保健, 2021, 27(1): 64-67.
26.	Chen X, Hou L, Zhang Y, et al. Analysis of the prevalence of sarcopenia and its risk factors in the elderly in the Chengdu community. J Nutr Health Aging, 2021, 25(5): 600-605.
27.	Li F, Bian D, Bai T, et al. Cognitive impairment is associated with sarcopenia mainly related to attention and calculation in hospitalized Chinese elderly men. Asia Pac J Clin Nutr, 2022, 31(3): 534-542.
28.	Liu X, Hao Q, Yue J, et al. Sarcopenia, obesity and sarcopenia obesity in comparison: prevalence, metabolic profile, and key differences: results from WCHAT study. J Nutr Health Aging, 2020, 24(4): 429-437.
29.	Shin HE, Kim M, Won CW. Differences in characteristics between older adults meeting criteria for sarcopenia and possible sarcopenia: from research to primary care. Int J Environ Res Public Health, 2022, 19(7): 4312.
30.	Wu B, Lyu YB, Cao ZJ, et al. Associations of sarcopenia, handgrip strength and calf circumference with cognitive impairment among chinese older adults. Biomed Environ Sci, 2021, 34(11): 859-870.
31.	Alexandre Tda S, Duarte YA, Santos JL, et al. Prevalence and associated factors of sarcopenia among elderly in Brazil: findings from the SABE study. J Nutr Health Aging, 2014, 18(3): 284-290.
32.	Beaudart C, Reginster JY, Petermans J, et al. Quality of life and physical components linked to sarcopenia: the SarcoPhAge study. Exp Gerontol, 2015, 69: 103-110.
33.	Endo T, Akai K, Kijima T, et al. An association analysis between hypertension, dementia, and depression and the phases of pre-sarcopenia to sarcopenia: a cross-sectional analysis. PLoS One, 2021, 16(7): e0252784.
34.	Hao Q, Hu X, Xie L, et al. Prevalence of sarcopenia and associated factors in hospitalised older patients: a cross-sectional study. Australas J Ageing, 2018, 37(1): 62-67.
35.	Hsu YH, Liang CK, Chou MY, et al. Association of cognitive impairment, depressive symptoms and sarcopenia among healthy older men in the veterans retirement community in southern Taiwan: a cross-sectional study. Geriatr Gerontol Int, 2014, 14(Suppl 1): 102-108.
36.	Huang CY, Hwang AC, Liu LK, et al. Association of dynapenia, sarcopenia, and cognitive impairment among community-dwelling older Taiwanese. Rejuvenation Res, 2016, 19(1): 71-78.
37.	Kamo T, Ishii H, Suzuki K, et al. Prevalence of sarcopenia and its association with activities of daily living among japanese nursing home residents. Geriatr Nurs, 2018, 39(5): 528-533.
38.	Maeda K, Akagi J. Cognitive impairment is independently associated with definitive and possible sarcopenia in hospitalized older adults: the prevalence and impact of comorbidities. Geriatr Gerontol Int, 2017, 17(7): 1048-1056.
39.	Yalcin A, Aras S, Atmis V, et al. Sarcopenia prevalence and factors associated with sarcopenia in older people living in a nursing home in Ankara Turkey. Geriatr Gerontol Int, 2016, 16(8): 903-910.
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41.	张栌尹, 莫永珍, 欧阳晓俊, 等. 肌少症合并认知障碍对老年病人出院后不良预后的影响. 实用老年医学, 2022, 36(1): 31-36.
42.	Aliberti MJR, Szlejf C, Covinsky KE, et al. Prognostic value of a rapid sarcopenia measure in acutely ill older adults. Clin Nutr, 2020, 39(7): 2114-2120.
43.	Kitamura A, Seino S, Abe T, et al. Sarcopenia: prevalence, associated factors, and the risk of mortality and disability in Japanese older adults. J Cachexia Sarcopenia Muscle, 2021, 12(1): 30-38.
44.	Salinas-Rodríguez A, Palazuelos-González R, Rivera-Almaraz A, et al. Longitudinal association of sarcopenia and mild cognitive impairment among older Mexican adults. J Cachexia Sarcopenia Muscle, 2021, 12(6): 1848-1859.
45.	Zengarini E, Giacconi R, Mancinelli L, et al. Prognosis and interplay of cognitive impairment and sarcopenia in older adults discharged from acute care hospitals. J Clin Med, 2019, 8(10): 1693.
46.	Lu Y, Liu C, Yu D, et al. Prevalence of mild cognitive impairment in community-dwelling Chinese populations aged over 55 years: a meta-analysis and systematic review. BMC Geriatr, 2021, 21(1): 10.
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48.	Meng SJ, Yu LJ. Oxidative stress, molecular inflammation and sarcopenia. Int J Mol Sci, 2010, 11(4): 1509-1526.
49.	Borst SE. Interventions for sarcopenia and muscle weakness in older people. Age Ageing, 2004, 33(6): 548-555.
50.	Licastro F, Pedrini S, Caputo L, et al. Increased plasma levels of interleukin-1, interleukin-6 and alpha-1-antichymotrypsin in patients with Alzheimer's disease: peripheral inflammation or signals from the brain? J Neuroimmunol, 2000, 103(1): 97-102.
51.	Mangialasche F, Polidori MC, Monastero R, et al. Biomarkers of oxidative and nitrosative damage in Alzheimer's disease and mild cognitive impairment. Ageing Res Rev, 2009, 8(4): 285-305.
52.	Baker LD, Barsness SM, Borson S, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Arch Neurol, 2012, 69(11): 1420-1429.
53.	Chen X, Han P, Yu X, et al. Relationships between sarcopenia, depressive symptoms, and mild cognitive impairment in Chinese community-dwelling older adults. J Affect Disord, 2021, 286: 71-77.
54.	Sui SX, Holloway-Kew KL, Hyde NK, et al. Muscle strength and gait speed rather than lean mass are better indicators for poor cognitive function in older men. Sci Rep, 2020, 10(1): 10367.
55.	Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 2019, 48(4): 601.
56.	李彩绒, 杨青岩. 肌少症诊断方式的研究进展. 西藏医药, 2022, 43(6): 153-154.
57.	Kawakami R, Murakami H, Sanada K, et al. Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia in Japanese men and women. Geriatr Gerontol Int, 2015, 15(8): 969-976.
58.	Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing, 2010, 39(4): 412-423.
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60.	Pinto TCC, Machado L, Bulgacov TM, et al. Is the montreal cognitive assessment (MoCA) screening superior to the mini-mental state examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly? Int Psychogeriatr, 2019, 31(4): 491-504.
61.	Lachat C, Roberfroid D, Van den Broeck L, et al. A decade of nutrition research in Africa: assessment of the evidence base and academic collaboration. Public Health Nutr, 2015, 18(10): 1890-1897.
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1. Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc, 2020, 21(3): 300-307.
2. Vellas B, Fielding RA, Bens C, et al. Implications of ICD-10 for sarcopenia clinical practice and clinical trials: report by the international conference on frailty and sarcopenia research task force. J Frailty Aging, 2018, 7(1): 2-9.
3. Malmstrom TK, Miller DK, Simonsick EM, et al. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle, 2016, 7(1): 28-36.
4. Bischoff-Ferrari HA, Orav JE, Kanis JA, et al. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int, 2015, 26(12): 2793-2802.
5. Schaap LA, van Schoor NM, Lips P, et al. Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures: the longitudinal aging study amsterdam. J Gerontol A Biol Sci Med Sci, 2018, 73(9): 1199-1204.
6. Beaudart C, Biver E, Reginster JY, et al. Validation of the SarQoL®, a specific health-related quality of life questionnaire for Sarcopenia. J Cachexia Sarcopenia Muscle, 2017, 8(2): 238-244.
7. De Buyser SL, Petrovic M, Taes YE, et al. Validation of the FNIH sarcopenia criteria and SOF frailty index as predictors of long-term mortality in ambulatory older men. Age Ageing, 2016, 45(5): 602-608.
8. Petermann-Rocha F, Balntzi V, Gray SR, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle, 2022, 13(1): 86-99.
9. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the national institute on aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement, 2011, 7(3): 263-269.
10. Dubois B, Villain N, Frisoni GB, et al. Clinical diagnosis of Alzheimer's disease: recommendations of the International Working Group. Lancet Neurol, 2021, 20(6): 484-496.
11. Jia J, Wei C, Chen S, et al. The cost of Alzheimer's disease in China and re-estimation of costs worldwide. Alzheimers Dement, 2018, 14(4): 483-491.
12. Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet, 2019, 393(10191): 2636-2646.
13. Dhillon RJ, Hasni S. Pathogenesis and management of sarcopenia. Clin Geriatr Med, 2017, 33(1): 17-26.
14. Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA, 2014, 312(23): 2551-2561.
15. Bai A, Xu W, Sun J, et al. Associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old. BMC Geriatr, 2021, 21(1): 292.
16. Beeri MS, Leugrans SE, Delbono O, et al. Sarcopenia is associated with incident Alzheimer's dementia, mild cognitive impairment, and cognitive decline. J Am Geriatr Soc, 2021, 69(7): 1826-1835.
17. Peng TC, Chen WL, Wu LW, et al. Sarcopenia and cognitive impairment: a systematic review and meta-analysis. Clin Nutr, 2020, 39(9): 2695-2701.
18. Jacob L, Kostev K, Smith L, et al. Sarcopenia and mild cognitive impairment in older adults from six low- and middle-income countries. J Alzheimers Dis, 2021, 82(4): 1745-1754.
19. Kim M, Won CW. Sarcopenia is associated with cognitive impairment mainly due to slow gait speed: results from the Korean frailty and aging cohort study (KFACS). Int J Environ Res Public Health, 2019, 16(9): 1491.
20. Rodríguez-Rejón AI, Artacho R, Ruiz-López MD. Anthropometric measurements and cognitive impairment rather than nutrition status are associated with sarcopenia in long-term care residents. Nutr Clin Pract, 2020, 35(4): 642-648.
21. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
22. Stang A, Jonas S, Poole C. Case study in major quotation errors: a critical commentary on the Newcastle-Ottawa scale. Eur J Epidemiol, 2018, 33(11): 1025-1031.
23. 陆冰, 刘晔, 陈吉海, 等. 住院老年患者血浆同型半胱氨酸水平与肌少症的相关性研究. 中华全科医学, 2021, 19(11): 1819-1822.
24. 王雨婷, 郝秋奎, 苏琳, 等. 我国社区老年人肌少症与认知功能受损的关系研究. 四川大学学报(医学版), 2018, 49(5): 793-796.
25. 张栌尹, 莫永珍, 欧阳晓俊, 等. 住院老年患者肌少症患病率及相关因素分析. 老年医学与保健, 2021, 27(1): 64-67.
26. Chen X, Hou L, Zhang Y, et al. Analysis of the prevalence of sarcopenia and its risk factors in the elderly in the Chengdu community. J Nutr Health Aging, 2021, 25(5): 600-605.
27. Li F, Bian D, Bai T, et al. Cognitive impairment is associated with sarcopenia mainly related to attention and calculation in hospitalized Chinese elderly men. Asia Pac J Clin Nutr, 2022, 31(3): 534-542.
28. Liu X, Hao Q, Yue J, et al. Sarcopenia, obesity and sarcopenia obesity in comparison: prevalence, metabolic profile, and key differences: results from WCHAT study. J Nutr Health Aging, 2020, 24(4): 429-437.
29. Shin HE, Kim M, Won CW. Differences in characteristics between older adults meeting criteria for sarcopenia and possible sarcopenia: from research to primary care. Int J Environ Res Public Health, 2022, 19(7): 4312.
30. Wu B, Lyu YB, Cao ZJ, et al. Associations of sarcopenia, handgrip strength and calf circumference with cognitive impairment among chinese older adults. Biomed Environ Sci, 2021, 34(11): 859-870.
31. Alexandre Tda S, Duarte YA, Santos JL, et al. Prevalence and associated factors of sarcopenia among elderly in Brazil: findings from the SABE study. J Nutr Health Aging, 2014, 18(3): 284-290.
32. Beaudart C, Reginster JY, Petermans J, et al. Quality of life and physical components linked to sarcopenia: the SarcoPhAge study. Exp Gerontol, 2015, 69: 103-110.
33. Endo T, Akai K, Kijima T, et al. An association analysis between hypertension, dementia, and depression and the phases of pre-sarcopenia to sarcopenia: a cross-sectional analysis. PLoS One, 2021, 16(7): e0252784.
34. Hao Q, Hu X, Xie L, et al. Prevalence of sarcopenia and associated factors in hospitalised older patients: a cross-sectional study. Australas J Ageing, 2018, 37(1): 62-67.
35. Hsu YH, Liang CK, Chou MY, et al. Association of cognitive impairment, depressive symptoms and sarcopenia among healthy older men in the veterans retirement community in southern Taiwan: a cross-sectional study. Geriatr Gerontol Int, 2014, 14(Suppl 1): 102-108.
36. Huang CY, Hwang AC, Liu LK, et al. Association of dynapenia, sarcopenia, and cognitive impairment among community-dwelling older Taiwanese. Rejuvenation Res, 2016, 19(1): 71-78.
37. Kamo T, Ishii H, Suzuki K, et al. Prevalence of sarcopenia and its association with activities of daily living among japanese nursing home residents. Geriatr Nurs, 2018, 39(5): 528-533.
38. Maeda K, Akagi J. Cognitive impairment is independently associated with definitive and possible sarcopenia in hospitalized older adults: the prevalence and impact of comorbidities. Geriatr Gerontol Int, 2017, 17(7): 1048-1056.
39. Yalcin A, Aras S, Atmis V, et al. Sarcopenia prevalence and factors associated with sarcopenia in older people living in a nursing home in Ankara Turkey. Geriatr Gerontol Int, 2016, 16(8): 903-910.
40. 张伟娟. 住院老年肌少症患者影响因素的分析. 乌鲁木齐: 新疆医科大学, 2022.
41. 张栌尹, 莫永珍, 欧阳晓俊, 等. 肌少症合并认知障碍对老年病人出院后不良预后的影响. 实用老年医学, 2022, 36(1): 31-36.
42. Aliberti MJR, Szlejf C, Covinsky KE, et al. Prognostic value of a rapid sarcopenia measure in acutely ill older adults. Clin Nutr, 2020, 39(7): 2114-2120.
43. Kitamura A, Seino S, Abe T, et al. Sarcopenia: prevalence, associated factors, and the risk of mortality and disability in Japanese older adults. J Cachexia Sarcopenia Muscle, 2021, 12(1): 30-38.
44. Salinas-Rodríguez A, Palazuelos-González R, Rivera-Almaraz A, et al. Longitudinal association of sarcopenia and mild cognitive impairment among older Mexican adults. J Cachexia Sarcopenia Muscle, 2021, 12(6): 1848-1859.
45. Zengarini E, Giacconi R, Mancinelli L, et al. Prognosis and interplay of cognitive impairment and sarcopenia in older adults discharged from acute care hospitals. J Clin Med, 2019, 8(10): 1693.
46. Lu Y, Liu C, Yu D, et al. Prevalence of mild cognitive impairment in community-dwelling Chinese populations aged over 55 years: a meta-analysis and systematic review. BMC Geriatr, 2021, 21(1): 10.
47. Beyer I, Mets T, Bautmans I. Chronic low-grade inflammation and age-related sarcopenia. Curr Opin Clin Nutr Metab Care, 2012, 15(1): 12-22.
48. Meng SJ, Yu LJ. Oxidative stress, molecular inflammation and sarcopenia. Int J Mol Sci, 2010, 11(4): 1509-1526.
49. Borst SE. Interventions for sarcopenia and muscle weakness in older people. Age Ageing, 2004, 33(6): 548-555.
50. Licastro F, Pedrini S, Caputo L, et al. Increased plasma levels of interleukin-1, interleukin-6 and alpha-1-antichymotrypsin in patients with Alzheimer's disease: peripheral inflammation or signals from the brain? J Neuroimmunol, 2000, 103(1): 97-102.
51. Mangialasche F, Polidori MC, Monastero R, et al. Biomarkers of oxidative and nitrosative damage in Alzheimer's disease and mild cognitive impairment. Ageing Res Rev, 2009, 8(4): 285-305.
52. Baker LD, Barsness SM, Borson S, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Arch Neurol, 2012, 69(11): 1420-1429.
53. Chen X, Han P, Yu X, et al. Relationships between sarcopenia, depressive symptoms, and mild cognitive impairment in Chinese community-dwelling older adults. J Affect Disord, 2021, 286: 71-77.
54. Sui SX, Holloway-Kew KL, Hyde NK, et al. Muscle strength and gait speed rather than lean mass are better indicators for poor cognitive function in older men. Sci Rep, 2020, 10(1): 10367.
55. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 2019, 48(4): 601.
56. 李彩绒, 杨青岩. 肌少症诊断方式的研究进展. 西藏医药, 2022, 43(6): 153-154.
57. Kawakami R, Murakami H, Sanada K, et al. Calf circumference as a surrogate marker of muscle mass for diagnosing sarcopenia in Japanese men and women. Geriatr Gerontol Int, 2015, 15(8): 969-976.
58. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing, 2010, 39(4): 412-423.
59. Jia X, Wang Z, Huang F, et al. A comparison of the mini-mental state examination (MMSE) with the montreal cognitive assessment (MoCA) for mild cognitive impairment screening in Chinese middle-aged and older population: a cross-sectional study. BMC Psychiatry, 2021, 21(1): 485.
60. Pinto TCC, Machado L, Bulgacov TM, et al. Is the montreal cognitive assessment (MoCA) screening superior to the mini-mental state examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly? Int Psychogeriatr, 2019, 31(4): 491-504.
61. Lachat C, Roberfroid D, Van den Broeck L, et al. A decade of nutrition research in Africa: assessment of the evidence base and academic collaboration. Public Health Nutr, 2015, 18(10): 1890-1897.
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