Obesity, sarcopenia, and depressive symptoms in patients with alzheimer's disease

Abstract

Objective: In this study, we intended to study the association between depressive symptoms and the status of sarcopenia or obesity in patients with mild-to-moderate Alzheimer's disease (AD). Methods: We enrolled 176 outpatients aged 65 to 89 years with mild-to-moderate AD. The study participants were divided into four groups according to the presence or absence of sarcopenia and obesity. We analyzed differences among the four groups and used multiple logistic regression to examine associations with depressive symptoms. Results: Most of the patients were obese without sarcopenia (n [%] = 94 [53.5%]). The patients with sarcopenia either with or without obesity were significantly more male, compared to those without sarcopenia (p < 0.001). The obese patients either with or without sarcopenia tended to be significantly older (p < 0.01), and to have significantly higher prevalence of depressive symptoms (p < 0.05), and significantly more receiving antidepressant therapy (p < 0.05), compared to those in the nonobesity groups. After adjusting for covariates, we further found that the obese patients either with or without sarcopenia were significantly positively associated with depressive symptoms compared to the nonsarcopenia/nonobesity group (odds ratio [OR] [95% confidence interval (CI)] = 6.88 [1.11–42.71], p < 0.05; OR [95% CI] = 5.95 [1.82–19.43], p < 0.01), respectively, and those patients with sarcopenia without obesity did not have any significant depressive symptoms. Conclusion: Obesity could be a potential confounder for the association between sarcopenia and depressive symptoms in patients with AD. Future studies suggest that depression interventions using reducing adiposity or increasing muscle mass need to be considered.