Abstract
PURPOSE: This study aimed to investigate the association between sarcopenia and cognitive function in Chinese patients with Parkinson's disease (PD). PATIENTS AND METHODS: This cross-sectional study included 148 patients with PD aged 60 years or older. Sarcopenia, nutritional status, and cognitive functioning were assessed using the 2019 Asian sarcopenia guidelines, the Mini Nutritional Assessment (MNA) scale, and the Montreal Cognitive Assessment (MoCA) scale, respectively. The relationship between sarcopenia and cognitive functioning was examined using multivariable logistic regression, receiver operating characteristic (ROC) analysis, and threshold effect analysis to identify the inflection point. Additionally, mediation analysis was performed to examine potential mediating variables. Subgroup analyses were also conducted to assess the robustness of the results across different populations. RESULTS: In the fully adjusted model, higher MoCA scores were significantly associated with lower odds of sarcopenia (OR = 0.78, 95% CI: 0.69-0.88, p = 0.0001), whereas higher Hamilton Anxiety Inventory (HAMA) scores (OR = 1.11, 95% CI: 1.02-1.21, p = 0.0133) and Hamilton Depression Inventory (HAMD) scores (OR = 1.16, 95% CI: 1.06-1.27, p = 0.0011) were significantly associated with higher odds of sarcopenia. This association was more pronounced in older participants and those with higher HAMA scores. In addition, the multivariable model adjusted for age, gender, BMI, and MoCA showed better discriminative ability for sarcopenia than MoCA alone (AUC: 0.828 vs. 0.778). E-value analysis suggested that the observed association was relatively robust to potential unmeasured confounding. CONCLUSION: Lower MoCA scores were independently associated with higher odds of sarcopenia in patients with PD. This association was more pronounced in older participants and those with higher anxiety scores. These findings suggest that cognitive assessment may help identify PD patients at increased likelihood of sarcopenia.