Sarcopenia and cognitive performance in hospitalized older adults: evidence of an association

OTAVIO SIMILI¹Lorena Natalino Haber Garcia¹Caroline Sollis¹Sandra Barbalho¹Marcelo Dib Bechara¹Caroline Barbalho Lamas²Cláudia Rucco Penteado Detregiachi¹KARINA QUESADA^1*

• ¹Universidade de Marília, Marilia, Brazil
• ²Universidade Federal de Sao Carlos, São Carlos, Brazil

Population aging increases the coexistence of geriatric syndromes, including sarcopenia and cognitive impairment, which negatively affect functional prognosis and clinical outcomes. Evidence on the association between sarcopenia and cognitive performance in hospitalized elderly individuals, especially across different cognitive domains, remains limited. This observational, cross-sectional study investigated these associations in elderly patients hospitalized in a medium-sized hospital in São Paulo, Brazil, from 2024 to 2025, assessed within the first 48 hours of admission. Exclusion criteria included patients on weight-loss diets, chronic renal failure undergoing dialysis, paresis or hemiparesis due to stroke, altered body fluid levels, pacemaker carriers, and chronic corticosteroid use. Sarcopenia screening and diagnosis followed the European Consensus criteria, and cognitive decline was assessed using the Mini-Mental State Examination (MMSE). Comparative analyses were conducted among non-sarcopenic, sarcopenia risk, and sarcopenic groups, and correlations with sociodemographic variables were examined. Eighty-four elderly individuals were evaluated (54.76% women; mean age 68.1 ± 6.7 years). Sarcopenia risk was observed in 29.76%, and confirmed sarcopenia in 19.05%. MMSE scores showed a moderate negative correlation with age (r = –0.48; p < 0.0001) and positive correlations with education (r = 0.58; p < 0.0001), physical activity (r = 0.31; p = 0.0038), and income (r = 0.23; p = 0.0326). Mean MMSE scores differed significantly among groups: non-sarcopenic (26.84 ± 3.24), sarcopenia risk (22.32 ± 5.86), and sarcopenic (18.69 ± 7.98) (p < 0.0001). Worse performance was observed in the domains of orientation, attention/calculation, and language in the groups with risk or confirmed sarcopenia (p < 0.001). These findings indicate that sarcopenia, even at early stages, is associated with impaired global cognitive performance and specific deficits in orientation, attention/calculation, and language in hospitalized elderly individuals. The results highlight the importance of early screening and targeted interventions to concurrently preserve muscle and cognitive health, emphasizing the need for integrated strategies in hospital settings.