TY - JOUR
T1 - Bone and Lean Mass Loss and Cognitive Impairment for Healthy Elder Adults
T2 - Analysis of the Nutrition and Health Survey in Taiwan 2013–2016 and a Validation Study With Structural Equation Modeling
AU - Lin, Sheng Feng
AU - Fan, Yen Chun
AU - Pan, Wen Harn
AU - Bai, Chyi Huey
N1 - Funding Information:
This study was funded by the Health Promotion Administration (HPA), Ministry of Health and Welfare, Taiwan (reference number: MOHW108-HPAH-114-134703 and MOHW109-HPA-H-114-144702), and by the Ministry of Science and Technology, Taiwan, in the form of a grant awarded to CHB (reference number: MOST 107-2314-B-038-072-MY3 and MOST 110-2314-B038-056-MY3). The content of this research may not represent the opinion of the Health Promotion Administration, Ministry of Health and Welfare, Taiwan.
Publisher Copyright:
© Copyright © 2021 Lin, Fan, Pan and Bai.
PY - 2021/10/13
Y1 - 2021/10/13
N2 - Purpose: Bone and lean mass loss and cognitive impairment are prevalent in elder adults and have been hypothesized to share a potential link. Methods: This nationwide cross-sectional study systemically sampled elder adults aged ≥65 years and conducted the door-to-door survey. The causal diagrams help to decide which covariates were included in the generalized linear mixed models (GLMMs). The structural equation modeling (SEM) was performed for the validation. Results: A total of 535 participants were enrolled and categorized into the normal (67.3%), mild cognitive impairment (18.3%), and dementia groups (14.4%). With increasing in the severity of cognitive impairment, the bone marrow density and lean mass consistently showed the trend of decreasing values. In the GLMMs, a significant association existed between the decrease of the bone mineral density (BMD) and the Mini-Mental State Examination (MMSE) (β = 5.819 scores per g/cm2 decrease, p = 0.0305) with adjustment of the age, sex, and physical activity. The SEM models confirmed that the MMSE was significantly and directly predicted by the age (β = 0.1363, p = 0.0003) and BMD (β = 0.1251, p = 0.0006) independently and indirectly predicted by lean mass (β = 0.1138, p = 0.0003) through the bone density path. Conclusion: In conclusion, an independent association between bone loss and cognitive impairment was existed rather than the confounding effect and the decrease of lean mass indirectly contributed to cognitive impairment by influencing the bone density.
AB - Purpose: Bone and lean mass loss and cognitive impairment are prevalent in elder adults and have been hypothesized to share a potential link. Methods: This nationwide cross-sectional study systemically sampled elder adults aged ≥65 years and conducted the door-to-door survey. The causal diagrams help to decide which covariates were included in the generalized linear mixed models (GLMMs). The structural equation modeling (SEM) was performed for the validation. Results: A total of 535 participants were enrolled and categorized into the normal (67.3%), mild cognitive impairment (18.3%), and dementia groups (14.4%). With increasing in the severity of cognitive impairment, the bone marrow density and lean mass consistently showed the trend of decreasing values. In the GLMMs, a significant association existed between the decrease of the bone mineral density (BMD) and the Mini-Mental State Examination (MMSE) (β = 5.819 scores per g/cm2 decrease, p = 0.0305) with adjustment of the age, sex, and physical activity. The SEM models confirmed that the MMSE was significantly and directly predicted by the age (β = 0.1363, p = 0.0003) and BMD (β = 0.1251, p = 0.0006) independently and indirectly predicted by lean mass (β = 0.1138, p = 0.0003) through the bone density path. Conclusion: In conclusion, an independent association between bone loss and cognitive impairment was existed rather than the confounding effect and the decrease of lean mass indirectly contributed to cognitive impairment by influencing the bone density.
KW - bone loss
KW - bone marrow density
KW - cognitive impairment
KW - dementia
KW - osteoporosis
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U2 - 10.3389/fnut.2021.747877
DO - 10.3389/fnut.2021.747877
M3 - Article
AN - SCOPUS:85118170390
SN - 2296-861X
VL - 8
JO - Frontiers in Nutrition
JF - Frontiers in Nutrition
M1 - 747877
ER -