Assessment of cognitive function and ultrasonographic muscle measurements' relationship with physical performance on individuals aged 40 years and older

Assessment of Cognitive Function and Ultrasonographic Muscle Measurements' Relationship With Physical Performance on Individuals Aged 40 Years and Older Introduction: Decreased physical performance in sarcopenia and frailty is associated with falls, fractures, prolonged hospitalization, poor quality of life and mortality. Physical performance, which is mainly associated with decrease in muscle mass, quality and strength, is defined as an objectively measured whole body function related with mobility. The aim of our study is the assessment of muscle measurements performed by ultrasonography (US) and cognitive functions relationship with physical performance. Materials and Methods: A total of 115 individuals, 42 males and 73 females, aged 40 and over, who were admitted to Hacettepe University Department of Physical Medicine and Rehabilitation, were included in the study. Demographic data and anthropometric measurements of individuals were recorded. Physical performance and muscle strength assessment were evaluated with gait speed, timed up and go test (TUG), 5 times sit to stand test (CST) and handgrip strength. Muscle thickness was measured by US from the arm, forearm and anterior thigh regions. Cognitive functions were evaluated with Mini-Mental State Examination (MMSE). Physical performance parameters, handgrip strength and thigh muscle thickness adjusted by body mass index (or sonographic thigh adjustment ratio) were used for the diagnosis of sarcopenia. Results: The mean age of the individuals was 61.9±12.5 years in males and 63.1±12.4 in females (p>0.05). Gait speed was with MMSE in males (β=0.616, p<0.001) and females (β=0.223, p=0.037). There was no association between gait speed and thigh muscle thickness (p>0.05). SMMT was associated with TUG (β=-0.201, p=0.035) and CST (β=-0.208, p=0.042) in women, but not in men. There were negative correlations between TUG and thigh muscle thickness in males (r=-0.341, p<0.05) and females (r=-0.320, p<0.01), and negative correlation between CST and thigh muscle thickness only in women (r=-0.314, p<0.01). All functional parameters were correlated with age. A negative correlation was found between age and thigh muscle thickness in males (r=-0.442, p<0.01) and females (r=-0.440, p<0.01), not with arm muscle. Age (OR=1.093, 95%CI: 1.016-1.175) and presence of hypertension (OR=11.931, 95%CI: 1.416-100.555) were independently associated with sarcopenia. Conclusion: The effect of cognitive functions as well as the effect of muscle mass on physical performance should be considered. Age-related muscle loss is not uniform whole body, therefore US can be used in regional muscle assessment. Key words: Physical performance, ultrasonography, muscle, cognitive, sarcopenia