Women at risk for sarcopenia are more vulnerable to cognitive decline, while those who have ever used menopausal hormone therapy are at a reduced risk of developing mild cognitive impairment (MCI), according to a new study published in the journal Maturitas.¹

The present study was a sub-analysis of a cross-sectional study involving postmenopausal women from nine Latin American countries. It included 772 women with natural menopause from an initial sample of 1185. Their mean age was 56.9 years. The mean BMI was 26.8 kg/m2 and the mean years of education were 13.6.

The objective of the study was to determine if the SARC-F, a five-question survey tool typically used to screen for sarcopenia risk, could also predict mild cognitive impairment (MCI) diagnosed using the Montreal Cognitive Assessment (MoCA) tool. SARC-F screens for Strength, Assistance in walking, Rise from a chair, Climb stairs and Falls. The Montreal Cognitive Assessment (MoCA) is a 30-point scale used to detect cognitive impairment.

Women with MCI had a higher BMI, more children, severe menopausal symptoms, were homemakers, and tended to be physically inactive. The prevalence of MCI rose from 12.9% in women with no sarcopenia risk (SARC-F <4) to 35.3% in those at risk (SARC-F ≥4) with odds ratio (OR) of 3.70. Furthermore, the risk of sarcopenia (SARC-F ≥4) was associated with MCI (OR: 2.44). Being a homemaker was also linked to a higher MCI risk (OR 1.97).

Use of menopausal hormone therapy and higher education were found to be protective with ORs of 0.26 and 0.28, respectively. The sensitivity and specificity for SARC-F for detecting MCI was 84% and 39%, respectively.

Hence, the SARC-F questionnaire, traditionally used to assess sarcopenia risk, may also serve as a simple, low-cost tool to identify postmenopausal women at higher risk for mild cognitive impairment. By highlighting the association between sarcopenia and cognitive impairment, this study suggests the need for a multidisciplinary approach in postmenopausal care, including lifestyle interventions mainly targeted at the high risk groups such as physically inactive women, homemakers, and those with a higher BMI as shown in this study. However, the authors call for further research to validate these preliminary findings.

Reference

1.   María S Vallejo, et al. Risk of sarcopenia: A red flag for cognitive decline in postmenopause? Maturitas. 2025 Mar:194:108193. doi: 10.1016/j.maturitas.2025.108193.