Incident Impaired Cognitive Function in Sarcopenic Obesity: Data From the National Health and Aging Trends Survey

John A. Batsis, Christian Haudenschild, Robert M. Roth, Tyler L. Gooding, Meredith N. Roderka, Travis Masterson, John Brand, Matthew C. Lohman, Todd A. Mackenzie

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Objectives: The prevalence of obesity with sarcopenia is increasing in adults aged ≥65 years. This geriatric syndrome places individuals at risk for synergistic complications that leads to long-term functional decline. We ascertained the relationship between sarcopenic obesity and incident long-term impaired global cognitive function in a representative US population. Design: A longitudinal, secondary data set analysis using the National Health and Aging Trends Survey. Setting: Community-based older adults in the United States. Participants: Participants without baseline impaired cognitive function aged ≥65 years with grip strength and body mass index measures. Methods: Sarcopenia was defined using the Foundation for the National Institutes of Health Sarcopenia Project grip strength cut points (men <35.5 kg; women <20 kg), and obesity was defined using standard body mass index (BMI) categories. Impaired global cognition was identified as impairment in the Alzheimer's Disease-8 score or immediate/delayed recall, orientation, clock-draw test, date/person recall. Proportional hazard models ascertained the risk of impaired cognitive function over 8 years (referent = neither obesity or sarcopenia). Results: Of the 5822 participants (55.7% women), median age category was 75 to 80, and mean grip strength and BMI were 26.4 kg and 27.5 kg/m2, respectively. Baseline prevalence of sarcopenic obesity was 12.9%, with an observed subset of 21.2% participants having impaired cognitive function at follow-up. Compared with those without sarcopenia or obesity, the risk of impaired cognitive function was no different in obesity alone [hazard ratio (HR) 0.98; 95% confidence interval (CI) 0.82–1.16]), but was significantly higher in sarcopenia (HR 1.60; 95% CI 1.42–1.80) and sarcopenic obesity (HR 1.20; 95% CI 1.03–1.40). There was no significant interaction term between sarcopenia and obesity. Conclusions: Both sarcopenia and sarcopenic obesity are associated with an increased long-term risk of impaired cognitive function in older adults.

Original languageEnglish (US)
Pages (from-to)865-872.e5
JournalJournal of the American Medical Directors Association
Issue number4
StatePublished - Apr 2021

All Science Journal Classification (ASJC) codes

  • General Nursing
  • Health Policy
  • Geriatrics and Gerontology


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