Loss of Skeletal muscle mass associated with cognitive decline in diabetes patients

Loss of Skeletal muscle mass was  associated with cognitive decline in diabetes patients, according to a new study. Further the bio-impedance analysis (BIA) measure of muscle mass loss over time was independently linked to general cognitive deterioration as well as declines in memory and visuo-spatial/construction skills among thes patients.

The new study has been published in the Journal of Diabetes and its Complications.

Serena Low and colleagues looked at the long-term relationship between skeletal muscle mass (SMM) loss and cognitive deterioration in type 2 diabetes mellitus in this study.

With follow-up intervals ranging from 1.6 to 6.4 years, researchers conducted a prospective cohort analysis with 453 patients from the SMART2D cohort. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Bio-Impedance Analysis Skeletal Muscle Mass Index (SMI) assessments were used as baseline and follow-up measurements, respectively. Using linear regression and correcting for demographics, education, depression, clinical co-variables, and the existence of the apolipoprotein E4 (APOE) Ɛ4 allele, the relationship between yearly rate of SMI and RBANS scores was examined.

The key findings of this study were:

1. The group with a larger SMI drop (Tertile 3 SMI change) exhibited a 0.30 decline in RBANS total score (95%CI 0.57 to 0.03; p = 0.030) in the adjusted analysis compared to individuals with Tertile 1 SMI change.

2. The Tertile 3 SMI change group had lower RBANS scores for the immediate memory and visuo-spatial/construction subdomains, with corresponding coefficients of 0.54 (95%CI 1.01 to 0.06; p = 0.026) and 0.71 (95%CI 1.30 to 0.12; p = 0.019), respectively.

In conclusion, the loss of skeletal muscle mass should encourage the doctor to evaluate for associated memory and visuospatial impairment and discuss strategies to improve areas of self-care including blood glucose monitoring and medication adherence. A memory service integrated within a thorough, multidisciplinary diabetes treatment might track subjective or objective cognitive impairment.

Reference: 

Low, S., Goh, K. S., Ng, T. P., Moh, A., Ang, S. F., Khoo, J., Ang, K., Yap, P., Cheong, C. Y., Tang, W. E., Lim, Z., Subramaniam, T., Sum, C. F., & Lim, S. C. (2022). Decline in skeletal muscle mass is associated with cognitive decline in type 2 diabetes mellitus. In Journal of Diabetes and its Complications (Vol. 36, Issue 9, p. 108258). Elsevier BV. https://doi.org/10.1016/j.jdiacomp.2022.108258