Association of Performance on Multiple Cognitive Domains with Sarcopenia among Middle-Aged and Older Adults

<b><i>Introduction:</i></b> The relationship between cognitive function and subsequent sarcopenia remains unclear. Therefore, this study aimed to examine the associations of performance on multiple cognitive domains with sarcopenia in the middle-aged and older adults. <b><i>Methods:</i></b> This longitudinal analysis (wave 2011–2013) included 2,934 participants from the CHARLS study. Sarcopenia was defined by the Asian Sarcopenia Working Group 2019 criteria. Cognitive function was measured by the Chinese version of the Mini-Mental State Examination (MMSE). Three interpretable techniques, namely SHapley Additive exPlanations (SHAP) and two built-in methods (coefficients of logistic regression and Gini importance of random forest), were used to assess the relationship between MMSE, its components (orientation, attention, episodic memory, and visuospatial ability) and sarcopenia. In addition, the association of MMSE score and its components with sarcopenia was further validated using stepwise regression. <b><i>Results:</i></b> All interpretable methods showed that MMSE score was important predictors of sarcopenia, especially the SHAP (MMSE score ranked top one). For its components, episodic memory, visuospatial ability, and attention showed high predictive value compared with orientation. Stepwise regression analyses showed that MMSE score and its components of episodic memory and visuospatial ability were correlated with sarcopenia, with their odds ratios of 0.93 (95% CI: 0.91–0.96, <i>p</i> &lt; 0.001), 0.87 (95% CI: 0.82–0.93, <i>p</i> &lt; 0.001), and 1.32 (95% CI: 1.05–1.65, <i>p</i> = 0.016), respectively. <b><i>Conclusions:</i></b> Better cognitive function especially episodic memory and visuospatial ability was negatively associated with incident sarcopenia among community middle-aged and older adults.