Motoric cognitive risk syndrome: Its prognostic value for dementia and other adverse age‐related health outcomes—A systematic review

Abstract

AbstractBackgroundMotoric Cognitive Risk (MCR), a syndrome combining objective slow gait speed and subjective cognitive complaints, is being used to identify older adults at high risk of developing dementia. Yet, uncertainty exists regarding the prognostic value of MCR for this and other major causes of morbidity in ageing, such as cognitive impairment and falls.This review is the first to synthesise all mental and physical health outcomes associated with MCR since the term was coined in 2013, and with its component parts of objective slow gait and subjective cognitive complaint prior to 2013. The aim of the review is to evaluate the prognostic value of MCR for adverse age‐related health outcomes.MethodResults from multiple databases (MEDLINE, AMED, EMBASE, CINAHL, PsycINFO, and the Cochrane library; inception to May 2021) for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non‐MCR group, for any health outcome were screened independently and risk of bias was assessed. We meta‐analysed incident health outcome results where appropriate using a restricted maximum‐likelihood estimator.ResultOf 1057 records identified, 15 studies were eligible. Of these, 11 studies that examined 15 cohorts were combined by meta‐analysis reporting on four health outcomes: cognitive impairment (n=6,458), dementia (n=9,955), falls (n=12,640), and mortality (n=19,818). Risk of bias was deemed low‐to‐moderate in all studies except one, where falls was the outcome. Our meta‐analysis found that participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio (aHR) 1.76, 95%CI 1.49–2.08; I2=24.9%), dementia (aHR 2.12, 1.85–2.42; 33.1%), falls (adjusted Relative Risk 1.38, 1.15–1.66; 62.1%), and mortality (aHR 1.49, 1.16–1.91; 79.2%), see figure 1.ConclusionEvidence suggests that participants with MCR at baseline are at an increased risk of cognitive impairment, dementia, falls, and mortality on follow‐up.