Work

Lung function as a mediator: bridging appendicular skeletal muscle mass and dementia in middle-aged and older Chinese adults

Year: 2026

Type: article

Abstract: BACKGROUND: The link between appendicular skeletal muscle mass (ASM) and dementia remains unclear. This study investigates whether lung function (LF) mediates the relationship between ASM and dementia in both cross-sectional and longitudinal analyses. METHODS: This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) collected between 2011 and 2018, involving 8,391 participants for cross-sectional and 5,053 for longitudinal analysis. Multivariate logistic regression and Cox proportional hazards models evaluated the links between ASM, LF, and dementia risk. Nonlinear dose-response relationships were assessed with restricted cubic spline (RCS) analysis, and subgroup analyses examined demographic differences. The R package mediation was used for causal mediation analysis, with 95% confidence intervals estimated via a nonparametric bootstrap method (1000 resamples). RESULTS: In the cross-sectional analysis, logistic regression showed that higher ASM was significantly linked to lower dementia prevalence (OR = 0.94, 95% CI 0.97-0.98, p = 0.009). LF was also strongly and non-linearly associated with lower dementia prevalence (OR = 0.69, 95% CI 0.57-0.85, p < 0.001; nonlinear p < 0.05 from RCS model). LF mediated 14.10% of the ASM-dementia link. In the longitudinal analysis, Cox models found that higher ASM reduced dementia risk (HR = 0.94, 95% CI 0.90-0.98, p = 0.005), as did LF (HR = 0.76, 95% CI 0.62-0.93, p = 0.008). LF accounted for 24.22% of the effect of ASM on dementia incidence. CONCLUSION: Higher ASM and better LF are independently linked to lower dementia risk, with LF partially mediating the ASM-dementia association. These results suggest that preserving muscle mass and LF may help prevent dementia in middle-aged and older adults.

Source: European journal of medical research

DOI: 10.1186/s40001-026-03972-2

Authors: Hong Ding, Yaning Yu, Laiguo Han, Jinguo Li, Changqing Li, Xiaojiang Zhao

Institutions: Bengbu Medical College, Shandong Labor Vocational and Technical College

Language: English

Topic: Dementia and Cognitive Impairment Research

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,190