Cross-Sectional Examination of Homocysteine Levels with Sarcopenia and Its Components in Memory Clinic Outpatients

Article type: Research Article

Authors: Yamada, Yosuke^a | Umegaki, Hiroyuki^{a; *} | Kinoshita, Fumie^b | Huang, Chi Hsien^{a; c; d} | Sugimoto, Taiki^e | Fujisawa, Chisato^a | Komiya, Hitoshi^a | Watanabe, Kazuhisa^a | Nagae, Masaaki^a | Kuzuya, Masafumi^a | Sakurai, Takashi^{e; f}

Affiliations: [a] Departments of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan | [b] Data Coordinating Center, Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan | [c] Department of Family Medicine, E-Da Hospital, Kaohsiung City, Taiwan, R.O.C. | [d] School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan, R.O.C. | [e] Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan | [f] Department of Cognition and Behavior Science, Graduate School of Medicine, Nagoya University, Nagoya, Japan

Correspondence: [*] Correspondence to: Dr. Hiroyuki Umegaki, Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan. Tel.: +81 52 744 2364; Fax: +81 52 744 2371; E-mail: umegaki@med.nagoya-u.ac.jp.

Abstract: Background:Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective:The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods:This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results:Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p < 0.001) or clinical diagnosis of dementia (β= –3.145, p < 0.001). These results were similar for men and women. Conclusion:Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.

Keywords: Cognitive impairment, hand grip strength, homocysteine, sarcopenia

DOI: 10.3233/JAD-210083

Journal: Journal of Alzheimer's Disease, vol. 82, no. 3, pp. 975-984, 2021