{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:29:58Z","timestamp":1753892998162,"version":"3.41.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cre\/BW has been widely validated as a reliable biomarker for assessing muscle mass in clinical and epidemiological studies. Accumulating evidence from longitudinal cohort studies has demonstrated a significant association between sarcopenia and progressive cognitive decline in aging populations. To further elucidate this relationship, we conducted a comprehensive analysis using data from a nationally representative survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study utilized longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS), with baseline measurements collected in 2012 and follow-up assessments conducted in 2018. To comprehensively evaluate the association between Cre\/BW and cognitive function, we employed a dual analytical approach. Cross-sectional analyses were performed using multivariable-adjusted linear regression models for continuous cognitive scores and logistic regression models for dichotomous cognitive outcomes. For longitudinal assessment, we implemented time-to-event analyses using Cox proportional hazards models, with rigorous adjustment for potential confounders including demographic characteristics, lifestyle factors, and comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Initial unadjusted linear regression analysis revealed a significant inverse association between Cre\/BW ratio and total cognitive function score (<jats:italic>\u03b2<\/jats:italic> =\u202f\u22120.111, 95% CI: \u22120.013 to \u22120.008, <jats:italic>p<\/jats:italic> &amp;lt;\u202f0.001). This association remained statistically significant after comprehensive adjustment for potential confounders, albeit with attenuated effect size (<jats:italic>\u03b2<\/jats:italic> =\u202f\u22120.052, 95% CI: \u22120.007 to \u22120.003, <jats:italic>p<\/jats:italic> &amp;lt;\u202f0.001). When analyzing cognitive function scores by quartiles, we observed a consistent pattern where lower Cre\/BW ratios were associated with better cognitive performance, even after multivariable adjustment (OR\u202f=\u202f0.973, 95% CI: 0.951 to 0.996, <jats:italic>p<\/jats:italic> =\u202f0.019). Longitudinal analysis using Cox proportional hazards models demonstrated that higher Cre\/BW ratios were significantly associated with increased risk of cognitive impairment (HR\u202f=\u202f1.207, 95% CI: 1.073 to 1.359, <jats:italic>p<\/jats:italic> =\u202f0.002). Notably, participants in the highest Cre\/BW quartile showed a 1.118-fold increased risk of cognitive impairment compared to those in the lowest quartile (95% CI: 1.048 to 1.346, <jats:italic>p<\/jats:italic> =\u202f0.007), suggesting a dose\u2013response relationship between Cre\/BW ratio and cognitive outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings demonstrate a significant inverse association between Cre\/BW and cognitive function in the general Chinese adult population. Longitudinal analysis revealed that elevated Cre\/BW ratio serves as an independent risk factor for cognitive impairment, with this association persisting after extended follow-up and comprehensive adjustment for potential confounding factors.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1494916","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T12:29:35Z","timestamp":1742992175000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between cognitive function and Cre\/BW in middle-aged and older Chinese adults: evidence from the CHARLS"],"prefix":"10.3389","volume":"13","author":[{"given":"Shuting","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengya","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanxue","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingmeng","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/j.cger.2017.02.005","article-title":"Mild cognitive impairment","volume":"33","author":"Sanford","year":"2017","journal-title":"Clin Geriatr 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