In a retrospective cohort study of older adults with primary hypertension, baseline sarcopenia was associated with an increased hazard of subsequent score-based cognitive decline over a median follow-up of 3.8 years. The single-center study analyzed 234 adults aged 60 years and older to evaluate whether baseline sarcopenia was associated with subsequent score-based cognitive decline.

To evaluate baseline muscle health, investigators applied the diagnostic criteria established by the Asian Working Group for Sarcopenia 2019. Across the analyzed cohort of 234 older individuals with primary hypertension, sarcopenia was identified in 58 participants at the start of the study, representing a baseline prevalence of 24.8 percent.

The study outcome was determined using formal threshold decreases on standardized cognitive screening instruments rather than clinical diagnoses alone. An event was defined as the first documented reduction from baseline of at least 3 points on the Mini-Mental State Examination or at least 2 points on the Montreal Cognitive Assessment, which was detected in 79 participants, or 33.8 percent of the cohort.

Associations between baseline sarcopenia and subsequent decline were evaluated using Cox proportional hazards regression. In the primary analysis adjusting for participant age, sex, and education, baseline sarcopenia was associated with a hazard ratio of 2.21, with a 95 percent confidence interval ranging from 1.37 to 3.56.

The research team also conducted exploratory analyses to assess alternative modeling assumptions and physical performance metrics. An expanded multivariable Model 3, which included 162 participants and 58 events, yielded a hazard ratio of 1.87 with a 95 percent confidence interval of 1.12 to 3.12. In an exploratory Fine–Gray model that accounted for death as a competing event, the subdistribution hazard ratio was 1.74 with a 95 percent confidence interval of 1.05 to 2.88. Additionally, an exploratory gait-speed analysis adjusted for muscle mass and grip strength found a hazard ratio of 1.12 (95 percent confidence interval, 1.01 to 1.25) per 0.1 meter-per-second decrease in walking speed.

A sensitivity analysis evaluated participants without preexisting cognitive issues by excluding 56 individuals with baseline mild cognitive impairment, resulting in an imprecise estimate with a hazard ratio of 1.72 (95 percent confidence interval, 0.98 to 3.02; P = 0.058). Consequently, the association among individuals without baseline mild cognitive impairment remains uncertain. The authors concluded that the retrospective cohort findings do not establish causality or clinical predictive utility and require confirmation through prospective cohorts with standardized assessments.

Subject of Research: Association between baseline sarcopenia and subsequent score-based cognitive decline in older adults with hypertension

Article Title: Sarcopenia and subsequent score-based cognitive decline in older adults with hypertension: a single-center retrospective cohort study

Article References: Pang, Z., Luo, D., & Zhang, C. (2026). Sarcopenia and subsequent score-based cognitive decline in older adults with hypertension: a single-center retrospective cohort study. Frontiers in Endocrinology, 17, Article 1930372. https://doi.org/10.3389/fendo.2026.1930372

Image Credits: AI Generated

DOI: 10.3389/fendo.2026.1930372

Keywords: sarcopenia, cognitive decline, hypertension, older adults, Asian Working Group for Sarcopenia, Mini-Mental State Examination, Montreal Cognitive Assessment, gait speed, grip strength, muscle mass, muscle-brain axis, retrospective cohort study, Cox regression, Fine-Gray model, competing risk analysis, mild cognitive impairment, geriatric endocrinology