Skip to main content
Download PDF
  • Research Article
  • Open access
  • Published:

Relationships between cognitive function and body composition among community-dwelling older adults: a cross-sectional study

BMC Geriatrics volume 17, Article number: 259 (2017) Cite this article

Abstract

Background

Previous studies reported mixed results regarding the association between cognition and body weight in late life. We evaluated the relationships between cognitive function and body composition among community-dwelling older adults.

Methods

Three hundred twenty subjects (≥65 years, women 53%) with available data of cognitive function and body composition from 2010 Hallym Aging Study. Cognitive function was assessed using Korean Mini-Mental State Examination (K-MMSE). Dual-energy X-ray absorptiometry (DEXA) was used for measuring body composition including body fat and lean body mass. Anthropometric measurements and laboratory data were collected in clinical examination. Body composition variables were divided into sex-specific tertiles, and examined by multivariable logistic regression.

Results

Among female, the highest tertile group of fat mass and second tertile group of total lean body mass were associated with lower risk for cognitive impairment compared to the respective first tertile groups (odds ratios, 0.23 and 0.09, respectively; 95% confidence intervals, 0.04–0.88 and 0.01–0.44, respectively) after adjusting for confounding factors. In male, higher arm bone mineral content was associated with lower risk for cognitive impairment, but significance was lost after adjusting for adiponectin, age, and education.

Conclusions

Higher fat mass and lean body mass were associated with lower risk of cognitive impairment in older women. These observations suggest that body fat and lean mass later in life might be beneficial for cognition.

Peer Review reports

Background

Dementia is a major cause of disability and one of the largest disease burdens in the older adult population. As the world’s population is rapidly aging, the number of people affected by dementia worldwide is expected to increase from 30 million in 2010 to 106 million in 2050 [1]. In Korea, the proportion of the population composed of older adults reached 7.2% in 2000, and is predicted to reach 14.3% by 2018, which is the most rapid aging of any nation [2]. Therefore, the burden of dementia in Korea will rapidly increase in the near future. Cognitive decline is a key feature of dementia, and early detection of cognitive impairment allows administration of appropriate treatment and slows the progression of dementia [3, 4]. Identification of risk factors associated with cognitive impairment and early intervention are important issues in the field of primary care for older adults.

Previous studies regarding the association between cognitive performance and body weight status reported inconsistent results. A large, retrospective cohort study in the UK reported that subjects with a higher body mass index (BMI) have a lower risk of dementia, suggesting the “obesity paradox” in dementia [5]. In addition, in an Italian population-based study, a higher BMI and higher body fat mass (BFM) were positively associated with better performance on cognitive tasks related to selective attention and executive functions [6]. The population-based, prospective Mayo Clinic Study of Aging suggested that a greater decrease in BMI per decade was associated with the mild cognitive impairment [7]. In the Sydney Memory and Aging Study, BMI and body fat measured by dual-energy X-ray absorptiometry (DEXA) were related to executive function, suggesting cognitive benefits in overweight older adults [8]. However, a longitudinal study (The TREVISO LONGEVA (TRELONG) Study) among northern Italian adults aged ≥70 years suggested that a high baseline BMI is risk factor for cognitive decline [9]. Few studies have involved Asian populations, which have lower BMI thresholds for overweight and obesity [10]. A Chinese study reported that central obesity or low BMI were significantly associated with the risk of cognitive impairment [11].

Although most previous studies used BMI to diagnose obesity, aging is accompanied by various changes in the body, such as decreasing height, lean body mass, and body fluid, and increasing fat mass [12, 13]. Therefore, BMI might not precisely reflect adiposity in older adults. Given these limitations of BMI, we used DEXA as a more accurate measure of body composition. To our knowledge, this is the first investigation of the relationships between DEXA measurements of body fat and cognitive performance in older Asian adults. Most previous studies did not consider geriatric depression, which might act as a confounding factor for declining cognition and decreasing body weight in the older adult population [14]. We adjusted for a wide range of covariates, including geriatric depression scale (GDS) and metabolic parameters.

In this study, we aimed to determine relationships between body phenotype and composition and cognitive function in older Korean adults, using 2010 data from the Hallym Aging Study.

Methods

Study population

The study population was selected from the Hallym Aging Study (HAS), details of which have been published elsewhere [15, 16]. Briefly, HAS is a prospective cohort consisting of community-dwelling adults in a small city in South Korea. The city was divided into 1408 areas based on the 2000 census, and 200 areas were selected randomly for this study. By systematic sampling, 30% of participants were sampled from adults aged 45–64 years, and 70% from adults aged ≥65 years. The first-wave survey in 2003 included 1520 subjects who did not have dementia. Among them, 918 participated in an in-depth clinical study in 2004. Among these 918 subjects, 547 agreed to participate in the 2007 follow-up examinations, and 382 agreed to participate in the 2010 follow-up examinations. We used the 2010 HAS data. The final study population was comprised of 320 subjects (≥65 years, women 53%) with available body composition and anthropometric data. The Institutional Review Board of Hallym University approved the study procedures, and all participants provided informed consent prior to enrollment in the study. The IRB allowed a legally authorized representative to provide informed consent on behalf of a decisionally impaired older adult (Additional file 1).

Measurements

To assess cognitive function, we used the Korean Mini-Mental State Examination (K-MMSE), which has been widely used in clinical evaluations and research in Korea [17]. K-MMSE consists of 23 items with a possible score of 30 points (5 for time orientation, 5 for place-orientation, 3 for memory registration, 5 for concentration and calculation, 3 for reminiscence, 8 for language and 1 for visual organization). Trained interviewers administered the K-MMSE at a separate space where the subject would not be disturbed for about10 minutes. Cognitive impairment was defined as below the 16th percentile using the age and education criteria [18].

Body fat and lean body mass were quantified by DEXA (Lunar, GE, Fairfield, CT, USA). Lean body mass consisted of skeletal muscle mass and bone mineral content. Anthropometric data were measured for subjects wearing light clothes and no shoes. Height was measured to the nearest 0.1 cm and weight to the nearest 0.1 kg in the upright position. BMI was calculated as weight divided by height squared (kg/m2). Waist circumference was measured at the midpoint between the upper end of the iliac crest and the lower end of the 12th rib at the end of each subject’s normal expiration to the nearest 0.1 cm using anthropometric tape. The waist-to-height ratio was calculated as waist circumference (cm)/height (cm). Blood pressure was measured using a standard protocol. All measurements were performed by a trained clinical team and quality control was monitored regularly.

Data regarding age, education level, medical history, and lifestyle factors, including smoking status, alcohol drinking, and regular exercise, were obtained using structured questionnaires administered in a face-to-face manner by trained interviewers. Education level was determined as a continuous variable. Individuals were classified into groups with “no formal education,” “1–5 years of education,” and “≥6 years of education”.

Fasting plasma glucose, total cholesterol (T-Chol), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were measured using an auto-analyzer (Hitachi 747, Hitachi, Tokyo, Japan). Low-density-lipoprotein cholesterol (LDL-C) was calculated by the Friedwald eq. (LDL-C = T-Chol–(HDL-C + TG/5)). The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using the following equation: fasting serum insulin (μU/mL) × fasting plasma glucose (mg/dL)/405. Adiponectin was measured using plasma samples stored at −70 °C by immunoassay (VersaMax, Molecular Devices, Sunnyvale, CA, USA). Glomerular filtration rate (GFR) was estimated using the four-variable Modification of Diet in Renal Disease (MDRD) Study equation.

Statistical analyses

Data are expressed as means ± standard deviations (SD) for continuous variables and frequencies (%) for categorical variables. The assumption of normality of the data was evaluated by the Shapiro–Wilk test, and a p-value greater than 0.05 indicated that the observed distribution of a variable was not significantly different from the normal distribution. HDL-C, TG, insulin, HOMA-IR, adiponectin levels, and K-MMSE were log-transformed, because they did not fit a normal distribution. We used Student’s t-test to compare continuous variables and the χ2 test or Fisher’s exact test to compare categorical variables between groups. We compared the demographic, metabolic, and body composition characteristics according to the presence of cognitive impairment in each sex. The independent variables that showed statistically significant differences between groups were included in the logistic regression model as covariates. Body composition variables were divided by sex-specific tertiles. Multivariable logistic regression with Firth’s penalized likelihood method was performed to estimate the adjusted odds ratio (OR) and 95% confidence interval (CI), and to assess the association between cognitive impairment and body composition. A p-value <0.05 was considered to indicate statistical significance. IBM SPSS Statistics version 20 (IBM Corp., Armonk, NY, USA) and R version 2.15.2 (http://www.r-project.org) were used for statistical analyses.

Results

The prevalence rates of cognitive impairment were 5.92% in males and 14.29% in females. Body fat percentage and fat mass were higher in females, whereas lean body mass, skeletal muscle mass, and bone mineral content (BMC) were higher in males. There was a significant difference in K-MMSE score, body phenotype and composition, and most of potentially confounding independent variables between males and females (Table 1). Therefore, we analyzed the data according to sex.

Table 1 General characteristics of the subjects
Full size table

The sex-specific general characteristics of the study subjects according to the presence of cognitive impairment are presented in Table 2. Mean age was significantly higher in the cognitive impairment group compared to the normal cognition group in both sexes. Among body phenotypes, BMI was higher only in female with normal cognition than in the cognitive impairment group (25.52 ± 3.58 and 23.73 ± 3.14, respectively, p = 0.016), whereas waist/height ratio was not significantly different between groups. Height was greater in the normal cognition group in both sexes.

Table 2 Characteristics of the study subjects with or without cognitive impairment according to sex
Full size table

With regard to body composition, arm BMC was higher in males in the normal cognition group than in those in the cognitive impairment group (0.37 ± 0.28 and 0.29 ± 0.07, respectively, p = 0.018). Fat mass and total lean body mass were significantly higher in females with normal cognitive function than in those in the cognitive impairment group (19.87 ± 5.69 and 16.97 ± 4.96, respectively, p = 0.014, 34.43 ± 4.36 and 33.31 ± 5.59, respectively, p = 0.029). In males, adiponectin level was lower in the normal cognition group than the cognitive impairment group (2.05 ± 0.55 and 2.48 ± 0.46, respectively, p = 0.026). In females, GDS score and rate of past history of MI were higher in the cognitive impairment group, whereas the prevalence of hypertension and educational level were higher in the normal cognition group.

We divided the body composition variables into sex-specific tertiles, and multivariable logistic regression analysis was performed to estimate the association between cognitive impairment and body composition. Among males, the highest tertile of arm BMC was associated with lower risk for cognitive impairment compared to the first tertile in model 1 (OR 0.10; 95% CI, 0.001–0.88), but significance was lost after adjusting for adiponectin, age, and education (Table 3). In females, the highest tertile group of fat mass and second tertile group of total lean body mass were associated with lower risk for cognitive impairment compared to the respective first tertile groups (OR 0.23 and 0.09, respectively; 95% CI, 0.04–0.88 and 0.01–0.44, respectively) after adjusting for confounding factors (Table 4). A past history of MI was associated with a greater risk of cognitive impairment, whereas treatment of hypertension was associated with lower risk of cognitive impairment. Height was not significantly associated with cognitive impairment in either sex.

Table 3 Multivariable adjusted odds ratios of cognitive impairment and body composition among males
Full size table
Table 4 Multivariable adjusted odds ratios of cognitive impairment and body composition among females
Full size table

Discussion

In this study, we investigated the relationship between cognitive function and body phenotype and composition. There have been several reports that height is related to cognitive function. An Israeli study reported that shorter stature was associated with lower cognition in elderly men with type 2 diabetes mellitus [19]. Shorter adults tend to have a smaller head circumference, which is associated with poorer brain reserve [20], and brain reserves allow individuals to preserve normal cognitive function despite brain degeneration due to aging [21]. However, in the present study, height was not associated with cognitive impairment in either sex, which was not consistent with the report of Quan et al. using the 2004 HAS data; they reported that the risk of cognitive impairment was fourfold higher in the shortest quartile than in the tallest quartile of men, but not in women [15]. However, this previous report had limitations in that it did not consider body weight or composition as well as various confounding factors, such as comorbidities and laboratory parameters.

We showed that BMI was significantly higher in females with normal cognition group than in the cognitive impairment group. The mean BMI of females with normal cognition was 25.5 kg/m2, which was similar to the obesity thresholds used in Asian population [10]. However, waist/height ratio as an indicator of central obesity showed no differences according to cognitive function in either sex. A retrospective cohort study in the UK reported that subjects with a higher BMI had a lower dementia risk [5]. Compared with those of a healthy weight, underweight persons (BMI <20 kg/m2) had a 34% higher (95% CI 29–38) risk of dementia. Furthermore, the incidence of dementia decreased for each increase in BMI category, with very obese individuals (BMI >40 kg/m2) having a 29% lower (95% CI 22–36) risk of dementia than those of a healthy weight. An Italian population-based study also reported that MMSE was positively associated with BMI and BFM calculated from skin fold thickness in both men and women [6]. Recent systematic reviews suggested an inverse association between obesity defined by BMI in late-life and dementia, consistent with the concept of the obesity paradox. However, they included 21 studies (only one Asian study), which had relatively short follow-up period, and did not consider sex-related differences [22].

Aging is accompanied by various changes in the body—such as decreasing height, lean body mass, and body fluid—whereas fat mass increases; therefore, the BMI in older adults might not precisely reflect their adiposity [12, 13]. Given these limitations of BMI, we used DEXA as a more accurate measure of body composition, and demonstrated that higher fat mass and lean mass were associated with lower risk of cognitive impairment in females.

Several possible mechanisms may explain how obesity, defined by excess adipose tissue, is related to cognitive function. First, body fat contains sex hormones and leptin, which may contribute to prevention of cognitive decline in older adults [23]. Second, a previous study reported that BMI was positively associated with greater white matter volume, suggesting that obesity increases myelin [24]. However, these positive associations between obesity and cognition could also result from the ‘survival bias’—obese individuals who live through middle age may have genes associated with higher cognitive function [25]. In addition, underweight and cognitive impairment might share an etiology. First, dysregulation of hormone secretion has been observed in anorexia, which could lead to a decline in cognitive function [26]. Second, an underweight status in the older adults may indicate preclinical dementia [27]. Third, underweight could also be a result of mental illness, such as depression. Geriatric depression might lead to both a decline in cognition and a decrease in body weight, which could act as confounding factors between cognition and body weight in older adults [14, 28]. However, in our study, the association between cognitive function and fat mass remained significant after adjusting for depression scores.

Previous studies suggested that loss of muscle mass and function, sarcopenia, might be related to brain atrophy and low cognitive performance [29]. We found that the second tertile group of total lean body mass in females showed lower risk for cognitive impairment compared to the first tertile group, however, there was no significant association in the third tertile group. In the Epidemiologie de l’Osteoporose (EPIDOS) cohort study, six definitions of sarcopenia were used, none of which was associated with cognitive impairment. However, a low gait speed and low handgrip strength were associated with cognitive impairment [30].

In the present study, interestingly, we found that a past history of MI was associated with higher risk of cognitive impairment in females, but not in males. However, there was no subject with a history of MI among nine males with cognitive impairment, and it was, therefore, difficult to judge the association between MI and cognitive function. This may be due to the relatively small sample size in our study or survival bias caused by high mortality of MI. Our findings suggested that physicians should pay attention to cognitive decline and consider dementia screening among older adults with a history of MI. The Women’s Health Initiative Memory Study reported that cardiovascular diseases, especially MI or angina, were associated with cognitive decline in elderly postmenopausal women [31]. When MI occurs, the blood supply to the heart and brain is decreased, which leads to loss of grey matter volume and cognitive impairment [32]. Further studies are warranted to investigate the mechanism underlying the association between MI and cognitive impairment.

This study had several limitations. First, it was of a cross-sectional design, which prevented making causal inferences between body composition and cognitive function. Second, because of the relatively small sample size, our results could not well represent the general Korean older adult population. To determine the influence of body composition on cognitive impairment, further large prospective studies are needed. Third, we used the MMSE to assess cognitive function. Although MMSE is the most commonly used screening test for dementia, the results of MMSE may not always match those of a detailed battery of cognitive tests.

Despite these limitations, our study confirmed the associations between specific components of body composition and cognitive function in an older adult Korean population. In addition, we used DEXA as a more accurate measure of body composition, and adjusted for a wide range of confounding factors, such as metabolic parameters and depression.

Conclusions

We demonstrated that higher fat mass and lean mass were associated with lower risk of cognitive impairment in older adult Korean women. Future studies should clarify the relationship between fat mass at older ages and cognitive function.

Abbreviations

BMI:

Body mass index

DEXA:

Dual-energy X-ray absorptiometry

GDS:

Geriatric depression scale

HAS:

Hallym Aging Study

K-MMSE:

Korean Mini-Mental State Examination

References

  1. Brookmeyer R, Johnson E, Ziegler-Graham K, Arrighi HM. Forecasting the global burden of Alzheimer's disease. Alzheimers Dement. 2007;3(3):186–91.

    Article  PubMed  Google Scholar 

  2. Park JH, Eum JH, Bold B, Cheong HK. Burden of disease due to dementia in the elderly population of Korea: present and future. BMC Public Health. 2013;13:293.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Siemers E. Designing clinical trials for early (pre-dementia) Alzheimer's disease: determining the appropriate population for treatment. J Nutr Health Aging. 2011;15(1):22–4.

    Article  CAS  PubMed  Google Scholar 

  4. Sperling RA, Aisen PS, Beckett LA, Bennett DA, Craft S, Fagan AM, Iwatsubo T, Jack CR Jr, Kaye J, Montine TJ, et al. Toward defining the preclinical stages of 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):280–92.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Qizilbash N, Gregson J, Johnson ME, Pearce N, Douglas I, Wing K, Evans SJ, Pocock SJBMI. Risk of dementia in two million people over two decades: a retrospective cohort study. Lancet Diabetes Endocrinol. 2015;3(6):431–6.

    Article  PubMed  Google Scholar 

  6. Tikhonoff V, Casiglia E, Guidotti F, Giordano N, Martini B, Mazza A, Spinella P, Palatini P. Body fat and the cognitive pattern: a population-based study. Obesity (Silver Spring). 2015;23(7):1502–10.

    Article  Google Scholar 

  7. Alhurani RE, Vassilaki M, Aakre JA, Mielke MM, Kremers WK, Machulda MM, Geda YE, Knopman DS, Peterson RC, Roberts RO. Decline in weight and incident mild cognitive impairment: Mayo Clinic study of aging. JAMA Neurol. 2016;

  8. Smith E, Bailey PE, Crawford J, Samaras K, Baune BT, Campbell L, Kochan N, Menant J, Sturnieks DL, Brodaty H, et al. Adiposity estimated using dual energy X-ray absorptiometry and body mass index and its association with cognition in elderly adults. J Am Geriatr Soc. 2014;62(12):2311–8.

    Article  PubMed  Google Scholar 

  9. Gallucci M, Mazzuco S, Ongaro F, Di Giorgi E, Mecocci P, Cesari M, Albani D, Forloni GL, Durante E, Gajo GB, et al. Body mass index, lifestyles, physical performance and cognitive decline: the "Treviso Longeva (TRELONG)" study. J Nutr Health Aging. 2013;17(4):378–84.

    Article  CAS  PubMed  Google Scholar 

  10. Deurenberg-Yap M, Yian TB, Kai CS, Deurenberg P, VANS WA. Manifestation Of cardiovascular risk factors at low levels of body mass index and waist-to-hip ratio in Singaporean Chinese. Asia Pac J Clin Nutr. 1999;8(3):177–83.

    Article  CAS  PubMed  Google Scholar 

  11. Cui GH, Guo HD, RF X, Jiang GX, Chen SD, Cheng Q. The association of weight status with cognitive impairment in the elderly population of a shanghai suburb. Asia Pac J Clin Nutr. 2013;22(1):74–82.

    PubMed  Google Scholar 

  12. Gallagher D, Visser M, Sepulveda D, Pierson RN, Harris T, Heymsfield SB. How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am J Epidemiol. 1996;143(3):228–39.

    Article  CAS  PubMed  Google Scholar 

  13. Bedogni G, Pietrobelli A, Heymsfield SB, Borghi A, Manzieri AM, Morini P, Battistini N, Salvioli GI. Body mass index a measure of adiposity in elderly women? Obes Res. 2001;9(1):17–20.

    Article  CAS  PubMed  Google Scholar 

  14. Huffman GB. Evaluating and treating unintentional weight loss in the elderly. Am Fam Physician. 2002;65(4):640–50.

    PubMed  Google Scholar 

  15. Quan SA, Jeong JY, Kim DH. The relationship between height and cognitive function among community-dwelling elderly: Hallym aging study. Epidemiol Health. 2013;35:e2013002.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Song HJ, OH S, Quan S, Ryu OH, Jeong JY, Hong KS, Kim DH. Gender differences in adiponectin levels and body composition in older adults: Hallym aging study. BMC Geriatr. 2014;14:8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Han C, Jo SA, Jo I, Kim E, Park MH, Kang Y. An adaptation of the Korean mini-mental state examination (K-MMSE) in elderly Koreans: demographic influence and population-based norms (the AGE study). Arch Gerontol Geriatr. 2008;47(3):302–10.

    Article  PubMed  Google Scholar 

  18. Kang YW. A Normative study of the Korean-mini mental state examination (K-MMSE) in the elderly. Korean Journal of Psychology. 2006;25(2):1–12.

    Google Scholar 

  19. West RK, Ravona-Springer R, Heymann A, Schmeidler J, Leroith D, Koifman K, Guerrero-Berroa E, Preiss R, Hoffman H, Silverman JM, et al. Shorter adult height is associated with poorer cognitive performance in elderly men with type II diabetes. J Alzheimers Dis. 2015;44(3):927–35.

    PubMed  Google Scholar 

  20. Perneczky R, Wagenpfeil S, Lunetta KL, Cupples LA, Green RC, Decarli C, Farrer LA, Kurz A, Group MS. Head circumference, atrophy, and cognition: implications for brain reserve in Alzheimer disease. Neurology. 2010;75(2):137–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Stern Y. What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society : JINS. 2002;8(3):448–60.

    Article  PubMed  Google Scholar 

  22. Pedditizi E, Peters R, Beckett N. The risk of overweight/obesity in mid-life and late life for the development of dementia: a systematic review and meta-analysis of longitudinal studies. Age Ageing. 2016;45(1):14–21.

    Article  PubMed  Google Scholar 

  23. Zeki Al Hazzouri A, Haan MN, Whitmer RA, Yaffe K, Neuhaus J. Central obesity, leptin and cognitive decline: the Sacramento area Latino study on aging. Dement Geriatr Cogn Disord. 2012;33(6):400–9.

    Article  CAS  PubMed  Google Scholar 

  24. Walther K, Birdsill AC, Glisky EL, Ryan L. Structural brain differences and cognitive functioning related to body mass index in older females. Hum Brain Mapp. 2010;31(7):1052–64.

    Article  PubMed  Google Scholar 

  25. Smith E, Hay P, Campbell L, Trollor JNA. Review of the association between obesity and cognitive function across the lifespan: implications for novel approaches to prevention and treatment. Obes Rev. 2011;12(9):740–55.

    Article  CAS  PubMed  Google Scholar 

  26. Gustafson D. Adiposity indices and dementia. Lancet Neurol. 2006;5(8):713–20.

    Article  PubMed  Google Scholar 

  27. Stewart R, Masaki K, Xue QL, Peila R, Petrovitch H, White LR, Launer LJ. A 32-year prospective study of change in body weight and incident dementia: the Honolulu-Asia aging study. Arch Neurol. 2005;62(1):55–60.

    Article  PubMed  Google Scholar 

  28. Tamura BK, Bell CL, Masaki KH, Amella EJ. Factors associated with weight loss, low BMI, and malnutrition among nursing home patients: a systematic review of the literature. J Am Med Dir Assoc. 2013;14(9):649–55.

    Article  PubMed  Google Scholar 

  29. Hsu YH, Liang CK, Chou MY, Liao MC, Lin YT, Chen LK, Lo YK. 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):102–8.

    Article  PubMed  Google Scholar 

  30. Abellan van Kan G, Cesari M, Gillette-Guyonnet S, Dupuy C, Nourhashemi F, Schott AM, Beauchet O, Annweiler C, Vellas B, Rolland Y. Sarcopenia and cognitive impairment in elderly women: results from the EPIDOS cohort. Age Ageing. 2013;42(2):196–202.

    Article  PubMed  Google Scholar 

  31. Haring B, Leng X, Robinson J, Johnson KC, Jackson RD, Beyth R, Wactawski-Wende J, von Ballmoos MW, Goveas JS, Kuller LH, et al. Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women's Health Initiative memory study. J Am Heart Assoc. 2013;2(6):e000369.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Almeida OP, Garrido GJ, Beer C, Lautenschlager NT, Arnolda L, Lenzo NP, Campbell A, Flicker L. Coronary heart disease is associated with regional grey matter volume loss: implications for cognitive function and behaviour. Intern Med J. 2008;38(7):599–606.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

This research was supported by Hallym University Research Fund (HURF-2015-33).

The Hallym Aging Study (HAS) was supported by grants from the Korea Research Foundation (047-BM1028).

Availability of data and materials

The datasets is available from the corresponding author on reasonable request.

Author information

Author notes

    Authors and Affiliations

    1. Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, South Korea

      Hye-Mi Noh, Hong Ji Song & Eun Young Lee

    2. Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea

      Sohee Oh

    3. Hallym Research Institute of Clinical Epidemiology, Hallym University, Chuncheon, South Korea

      Jin-Young Jeong

    4. Department of Endocrinology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, South Korea

      Ohk-Hyun Ryu

    5. Department of Cardiology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, South Korea

      Kyung-Soon Hong

    6. Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, South Korea

      Dong-Hyun Kim

    Authors
    1. Hye-Mi Noh
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Sohee Oh
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Hong Ji Song
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Eun Young Lee
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Jin-Young Jeong
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Ohk-Hyun Ryu
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Kyung-Soon Hong
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Dong-Hyun Kim
      View author publications

      You can also search for this author in PubMed Google Scholar

    Contributions

    HJS and HMN suggested the study. HJS, HMN, SO and DHK designed the study and developed the study protocol. SO, HMN and HJS analysed the data. All authors interpreted the results. HMN, SO and HJS drafted the manuscript. All authors contributed to the critical revision of the manuscript. DHK, HJS, HMN and SO has full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors read and approved the final manuscript.

    Corresponding authors

    Correspondence to Hong Ji Song or Dong-Hyun Kim.

    Ethics declarations

    Ethics approval and consent to participate

    The protocols and procedures of our study were approved by Institutional Review Board of Hallym University, and all participants provided informed consents before study enrollment. On behalf of decisionally impaired older adults, legally authorized representative provided the informed consents.

    Consent for publication

    Not applicable.

    Competing interests

    The authors declare that they have no competing interests.

    Publisher’s Note

    Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

    Additional file

    Additional file 1: Figure S1.

    Flowchart of the selection of the study population. (DOCX 23 kb)

    Rights and permissions

    Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Noh, HM., Oh, S., Song, H.J. et al. Relationships between cognitive function and body composition among community-dwelling older adults: a cross-sectional study. BMC Geriatr 17, 259 (2017). https://doi.org/10.1186/s12877-017-0651-9

    Download citation

    • Received:

    • Accepted:

    • Published:

    • DOI: https://doi.org/10.1186/s12877-017-0651-9

    Keywords

    BMC Geriatrics

    ISSN: 1471-2318

    Contact us