Subjective cognitive and motoric complaints as predictors of motoric cognitive risk syndrome

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AbstractBackgroundMotoric cognitive risk syndrome (MCR) is a pre‐dementia syndrome characterized by the presence of slow gait and cognitive complaints in non‐demented patients. Self‐reported subjective cognitive complaints (SCCs) have been shown to be harbingers of future cognitive decline. Likewise, subjective motoric complaints (SMC) are common with aging, and predict risk for future gait decline. Subjective complaints might have utility in screening and remote assessments. Our objective was to examine the validity of a subjective definition of MCR (presence of subjective motoric AND cognitive complaints) for predicting incident MCR defined using objective gait speed.MethodsFive SMC and 8 SCC questions (independent of the SCCs used in the objective MCR definition) were assessed in a sample of 501 non‐demented community‐dwelling adults age 65 and older. Cox proportional hazard models adjusted for age, sex, education, comorbidities and a test of global cognitive function were used to examine the association between subjective MCR (presence of SMC and SCC) and risk of incident objective MCR (defined as slow gait 1 standard deviation below age and sex means and SCC).ResultsAt baseline, 360 participants (71.1%) reported one or more subjective motoric complaints and 368 (72.7%) reported one or more SCCs. Two‐hundred seventy‐nine participants (55.1%) reported the presence of one or more of both SMC and SCCs (subjective MCR). Participants with subjective MCR were older (77.9 vs. 74.9) and more often female (61.4% vs. 48.4%) than those without subjective MCR. Of the 501 participants, 38 developed objective MCR over a median follow‐up 2.5 years. Subjective MCR was associated with increased risk of developing objective MCR (adjusted hazard ratio (aHR): 3.88, 95% Confidence Interval (CI): 1.58‐9.51). When subjective MCR was defined as the presence of 2 or more SMC and SCC, the association with objective MCR was stronger (aHR: 4.78, 95% CI: 2.45‐9.33).ConclusionsSubjectively defined MCR is associated with increased risk of incident MCR. Remote identification of people at high‐risk for MCR has potential for clinical and research applications especially given the social isolation imposed by the Covid‐19 pandemic.