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White matter hyperintensities: a possible link between sarcopenia and cognitive impairment in patients with mild to moderate Alzheimer’s disease

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Key summary points

AbstractSection Aim

To investigate the possible association between White matter hyperintensities and sarcopenic parameters in patients with Alzheimer’s disease.

AbstractSection Finding

Our findings showed that WMH volumes were correlated with cognitive impairment, as well as various sarcopenic parameters.

AbstractSection Message

Sarcopenia interventions may help improve cognitive function in patients with Alzheimer’s disease by decreasing the burden of WMH.

Abstract

Purpose

Alzheimer’s disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.

Methods

57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using 3D-slicer software.

Results

AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.

Conclusion

WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank all the participants in the study and the staff involved.

Funding

This work was supported by Application of Clinical Technology in Elderly Health Research Project in Jiangsu Province (LD2021031); Suzhou Science and Technology Plan Medical and Health Care Science and Technology Innovation Applied Basic Research (SKY2022161); Research Project of Neurological Diseases in the Second Affiliated Hospital of Suzhou University; Research Center (ND2023A01); Jiangsu Provincial Medical Key Discipline for the 14th Five-Year Plan (ZDXK202217).

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Author notes

  1. Xiaofen Weng and Shanwen Liu have contributed equally to this work and shared the first authorship.

Authors and Affiliations

  1. Department of Neurology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China

    Xiaofen Weng, Shanwen Liu, Chunfeng Liu & Hua Hu

  2. Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China

    Xiaofen Weng

  3. Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

    Meng Li & Jiangtao Zhu

  4. Department of Ultrasonography, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

    Yingchun Zhang

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  1. Xiaofen Weng
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Correspondence to Hua Hu.

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This study was approved by the ethics committee of the Second Affiliated Hospital of Soochow University (JD-LK-2021–049-01).

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Weng, X., Liu, S., Li, M. et al. White matter hyperintensities: a possible link between sarcopenia and cognitive impairment in patients with mild to moderate Alzheimer’s disease. Eur Geriatr Med 14, 1037–1047 (2023). https://doi.org/10.1007/s41999-023-00818-6

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