Highlights
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Goals
To examine the longitudinal association between skeletal muscle mass (SMM) loss and cognitive decline over time in type 2 diabetes mellitus (T2DM).
Methods
We conducted a prospective cohort study of 453 patients from the SMART2D cohort with follow-up intervals of 1.6 to 6.4 years. Baseline and follow-up measurements included bioimpedance analysis (BIA) measurement of skeletal muscle mass index (SMI) and repeatable battery for assessment of neuropsychological status (RBANS) measurement of cognitive function.
We examined the association between the annual rate of SMI and RBANS scores using linear regression, adjusting for demographics, education, depression, clinical covariates, and presence of the apolipoprotein E4 (APOE) Ɛ 4 allele.
Results
The mean age of the participants was 60.3 ± 7.4 years. Compared with patients with SMI Tertile 1 change, the group with the greatest SMI decrease (SMI Tertile 3 change) experienced a decrease of 0.30 in the RBANS total score (95% CI -0.57 to -0.03; p = 0.030) in the adjusted analysis.
RBANS scores for the immediate memory and visuospatial/construction subdomains were lower in the SMI Tertile 3 change group with corresponding coefficients -0.54 (95% CI -1.01 to -0.06; p = 0.026) and -0.71 (95% CI: -1.30) to -0.12; p = 0.019) respectively.
Conclusion
In patients with T2DM, the bioimpedance analysis (BIA) measure of muscle loss over time was independently associated with cognitive impairment globally and in the memory and visuospatial/construction domains.
Final message • Loss of muscle mass over time was associated with cognitive decline globally. • It was also associated with the domains of memory and construction/visuospatial. • It is potentially useful for monitoring changes in muscle mass in diabetes care. |
