Parâmetros da composição corporal e desempenho cognitivo (global e seus domínios) em pessoas idosas da comunidade: revisão sistemática e análise de caminhos

Abstract

Introduction: Aging is accompanied by changes in cognition and body composition. Although studies show the relationship between body composition indicators and cognitive performance, there are contradictory results about this relationship, as well as insufficient data on direct and indirect relationships between body composition components and cognitive performance and its domains. Objectives: the objective of this thesis was to analyze associations between the components of body composition and the cognitive performance of elderly people in the community. To meet the objective, two articles were developed with the objectives of: (1) analyzing previously described data on the association between body composition indicators and global cognitive performance and its domains in elderly people through a systematic literature review; (2) analyze the direct and indirect relationships between sociodemographic and health variables and body composition of elderly people with global cognitive performance and its domains. Method: the first article is a systematic review carried out in two stages, September 2020 and updated in July 2022, in four scientific databases available on the web, Virtual Health Library (VHL), Pubmed, Web of Science and Cinahl, using terms search engines recognized by DeCS (Health Sciences Descriptors) and MeSH (Medical Subject Headings). The second is a cross-sectional study with Path Analysis to verify associations between body composition components and global cognitive performance and domains. Body composition (Dual-energy X-ray absorptiometry – DEXA), cognition (Addenbrooke’s Cognitive Examination – Revised – ACE-R) and sociodemographic data (gender, age, education, income) and health (depressive symptoms and functionality). Descriptive analyzes and Path analysis were carried out. Descriptive analyzes and Path analysis were carried out. Results: (1) 25 studies were included in the review. The results showed that in women, obesity was associated with faster decline in cognitive domains; measures of adiposity were negatively correlated with verbal memory and attention; lower body mass index was related to faster decline in measures of global cognition, semantic memory and episodic memory; body mass index was positively associated with memory, visuospatial/structural ability, language, and Mini Mental State Examination scores; waist/hip ratio was negatively associated with attention. (2) The results showed a direct positive relationship between functional capacity and education with global cognition and the memory and visuospatial domains; functional capacity, education and fat mass on language skills; lean mass and functional capacity on the domain of attention and orientation and education on verbal fluency; direct negative relationships were observed between age and global cognition, memory and verbal fluency; income from attention and guidance; indirect relationships were observed between depressive symptoms and global cognition and memory domain and also between sex and memory domain, with fat mass as a probable mediating variable. Conclusion: there are associations between bodily components and total cognition, memory, attention and language domains. There was evidence of the mediating role of total fat mass in the relationship between depressive symptoms and global cognition and memory, as well as between sex and the memory domain. The accumulation of fat mass in the body, as well as the reduction of lean mass and cognitive impairment are frequent characteristics of aging and can cause harm to the lives of this population. The results may contribute to preventive actions in primary health care services.