Metabolic and functional correlates of first transitions to low muscle strength and memory reserve across four longitudinal cohorts
- 1The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China
- 2School of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou, Zhejiang, 310018, China
- 3The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China; Corresponding author.
Abstract
Background: Muscle strength and episodic memory are linked in later life, but factors associated with their first transitions to low reserve remain uncertain. Methods: We analyzed four longitudinal cohorts of adults aged 50–100 years with at least three synchronous strength and memory assessments. Participants entered follow-up when both cohort-standardized residual scores exceeded −1 SD. Continuous-time panel multistate models estimated muscle-first and memory-first transition intensities. Cohort-specific effects were pooled using random-effects meta-analysis with Hartung–Knapp inference. The primary contrast was the ratio of covariate-specific intensity ratios (IRRs) for memory-first versus muscle-first transitions. Results: The primary analysis included 46,356 participants, with 6,036 first observed muscle-first, 8,539 memory-first and 897 both-low transitions. Older age was associated with a relative memory-first pattern (IRR ratio per 5 years 1.110, 95% CI 1.082–1.139); activities of daily living (ADL) limitation was associated with a relative muscle-first pattern (0.664, 95% CI 0.559–0.788). Diabetes was associated with higher intensities in both domains, but its pathway contrast remained uncertain (0.751, 95% CI 0.554–1.019; P = 0.058). Age and ADL associations persisted after adjustment for baseline reserve and multimorbidity and when participants with two assessments were included. Age-specific SD thresholds attenuated the age contrast to 1.048 (95% CI 1.016–1.081). Diabetes findings varied with the low-reserve threshold. Conclusions: Age and ADL limitation were associated with different relative patterns of first low-reserve transitions. Diabetes was associated with higher transition intensities in both domains without a clear pathway difference at the primary threshold. These observational associations do not establish a biological sequence or clinical screening thresholds.
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BibTeX
@article{hu2026metabolic,
title = {{Metabolic and functional correlates of first transitions to low muscle strength and memory reserve across four longitudinal cohorts}},
author = {Haoyang Hu and Jiaxuan Peng and Zekai Yu and Fei Yang},
journal = {The Journal of Nutrition, Health and Aging},
year = {2026},
month = oct,
doi = {10.1016/j.jnha.2026.101013},
url = {https://doi.org/10.1016/j.jnha.2026.101013},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Metabolic and functional correlates of first transitions to low muscle strength and memory reserve across four longitudinal cohorts
AU - Haoyang Hu
AU - Jiaxuan Peng
AU - Zekai Yu
AU - Fei Yang
PY - 2026
DA - 2026/10/30
JO - The Journal of Nutrition, Health and Aging
DO - 10.1016/j.jnha.2026.101013
UR - https://doi.org/10.1016/j.jnha.2026.101013
AB - Background: Muscle strength and episodic memory are linked in later life, but factors associated with their first transitions to low reserve remain uncertain. Methods: We analyzed four longitudinal cohorts of adults aged 50–100 years with at least three synchronous strength and memory assessments. Participants entered follow-up when both cohort-standardized residual scores exceeded −1 SD. Continuous-time panel multistate models estimated muscle-first and memory-first transition intensities. Cohort-specific effects were pooled using random-effects meta-analysis with Hartung–Knapp inference. The primary contrast was the ratio of covariate-specific intensity ratios (IRRs) for memory-first versus muscle-first transitions. Results: The primary analysis included 46,356 participants, with 6,036 first observed muscle-first, 8,539 memory-first and 897 both-low transitions. Older age was associated with a relative memory-first pattern (IRR ratio per 5 years 1.110, 95% CI 1.082–1.139); activities of daily living (ADL) limitation was associated with a relative muscle-first pattern (0.664, 95% CI 0.559–0.788). Diabetes was associated with higher intensities in both domains, but its pathway contrast remained uncertain (0.751, 95% CI 0.554–1.019; P = 0.058). Age and ADL associations persisted after adjustment for baseline reserve and multimorbidity and when participants with two assessments were included. Age-specific SD thresholds attenuated the age contrast to 1.048 (95% CI 1.016–1.081). Diabetes findings varied with the low-reserve threshold. Conclusions: Age and ADL limitation were associated with different relative patterns of first low-reserve transitions. Diabetes was associated with higher transition intensities in both domains without a clear pathway difference at the primary threshold. These observational associations do not establish a biological sequence or clinical screening thresholds.
SN - 1760-4788
SN - 1279-7707
ER -