Associations between osteosarcopenia and cognitive function in community-dwelling older adults: evidence from a US cohort.

BACKGROUND

This study investigated domain-specific associations between osteosarcopenia, defined as the coexistence of osteopenia or osteoporosis with low handgrip strength (HGS), and cognitive function in a cohort of older adults (≥65 years) from the 2011 to 2014 cycles of the National Health and Nutrition Examination Survey (NHANES).

METHODS

Osteosarcopenia was defined by the presence of osteopenia or osteoporosis (based on femoral T-scores) combined with low HGS. Cognitive function was assessed using the Digit Symbol Substitution, Delayed Recall, Intrusion Word Count, and Animal Fluency tests. Linear regression models examined the bidirectional associations between osteosarcopenia and cognitive performance.

RESULTS

The sample included 1355 older adults (mean age 70.3 ± 6.9 years; 57% women). Compared to participants with osteoporosis alone, those with coexisting osteoporosis and low HGS performed significantly worse on the Digit Symbol Test (β = -9.6; 95% CI, -16.7 to -2.5; p = .01) and had similar Delayed Recall scores (β = -0.6; 95% CI, -1.3 to 0.1; p = .10). In participants with osteopenia and low HGS, a significant association was observed only for the Digit Symbol Test (β = -8.1; 95% CI, -13.4 to -2.7; p < .01). No significant associations were found for osteoporosis or osteopenia in isolation.

CONCLUSIONS

Osteosarcopenia, particularly the combination of reduced bone mineral density and low muscle strength, is associated with poorer performance in selected cognitive domains, especially processing speed and memory. These findings underscore the potential value of integrated screening approaches and multidimensional interventions targeting musculoskeletal and cognitive health in aging populations.