Papel sinérgico da insônia recorrente e da sarcopenia no comprometimento congnitivo e na deterioração funcional na longevidade

Abstract

As we get older, both sleep regulation and muscle development are affected, and it was known that insufficient sleep have detrimental effects on human tissues, accelerating the aging process and potentially contributing to the loss of skeletal muscle. Emerging evidence indicates that inadequate sleep can directly trigger muscle catabolism. This study aims to elucidate the interaction between insomnia and sarcopenia with cognitive impairment and functional decline, showing some possible mechanistic connections.This is a cross-sectional study, in which data from 493 individuals aged ≥80 years old were examined between 2016 and 2018. Sarcopenia was assessed using the SARC-F tool, and insomnia using the Insomnia Severity Index; dependence was estimated using Instrumental Activity of Daily Life and cognitive function was measured using the Mini-Mental State Examination scale. Initial assessments included analysis of blood lipids, IFNγ, IL-2, IL-4, IL-6, IL-10, PCR, and DNA methylation. Participants were stratified into four study subgroups according to the occurrence of sarcopenia, insomnia, both or neither. Insomnia alone has not been associated with cognitive impairment or functional dependence. However, sarcopenia only increased the odds of cognitive impairment by a factor of 2.6 (95% confidence interval [CI] 1.2 - 5.6, p = 0.011), although it did not impact functional decline. When examined together, insomnia and sarcopenia were associated with 4.8-fold increased odds of cognitive impairment (95% CI 2.1 - 10.9, p < 0.001) and 7.1-fold increased odds of functional decline (95% CI 1.7 - 29.0, p = 0.007). compared to those without any conditions. Lipid profiles and levels of inflammatory markers did not differ, but sarcopenic individuals showed significantly higher DNA methylation (p<0.001). Insomnia and sarcopenia synergistically increase the risk of cognitive impairment and functional decline among the oldest old. Sarcopenia itself impacted cognition in individuals, which may be related to the increase in DNA methylation, regardless of the manifestation observed among individuals with sarcopenia.