Elevated odds of cognitive impairment and sarcopenia risk among individuals with silicosis in a Chinese cohort

Silicosis, an incurable occupational lung disease caused by inhalation of crystalline silica dust, may be associated with cognitive impairment and sarcopenia risk, both linked to disability; however, silicosis-specific evidence remains limited. This cross-sectional study included 264 individuals with silicosis and 270 age- and sex-matched community controls (total n = 534, all Chinese adults aged ≥ 50 years). Cognitive function, disability (WHODAS 2.0), sarcopenia risk (SARC-F), social support, coping strategies, handgrip strength, skeletal muscle mass, and six-minute walk distance were assessed. Data were analyzed using chi-square tests, logistic and multiple linear regression. Individuals with silicosis had significantly higher disability scores (mean 33.77 vs. 23.05, p < 0.001). Prevalence of cognitive impairment was 49.6% in the silicosis group versus 8.8% in controls (adjusted odds ratio [aOR] 3.77, 95% CI 1.96–7.27). Prevalence of sarcopenia risk was 14.8% versus 2.2% (aOR 4.07, 95% CI 1.40–11.81 after sociodemographic and clinical adjustment). Cognitive function and sarcopenia risk, muscle strength and mass, together with covariates, explained 38% of the variance in disability scores (adjusted R²=0.38, p < 0.001). Silicosis is independently associated with increased odds of cognitive impairment and sarcopenia risk; both are associated with greater disability. Due to the cross-sectional design, causality cannot be inferred. Routine screening for these conditions in silicosis care warrants further evaluation.