Motoric Cognitive Risk Syndrome Research Articles

Association of cardiometabolic multimorbidity with motoric cognitive risk syndrome in older adults.

Motoric cognitive risk syndrome (MCR) is a predementia syndrome that is characterized by cognitive complaints and slow gait. Cardiometabolic multimorbidity (CMM) is associated with an increased risk of dementia. However, the relationship between CMM and MCR is still unclear. We included 4744 participants (aged 65+ years) without MCR at baseline from the National Health and Aging Trends Study (NHATS), who were followed-up from 2011 to 2018. CMM was defined as the presence of two or more cardiometabolic diseases (including diabetes mellitus, heart disease, and stroke). CMM was significantly associated with an increased risk of MCR (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.13-1.75) in fully adjusted models. Consistent results were observed from stratified analyses of different subgroups. Increasing numbers of cardiometabolic diseases were dose-dependently associated with increased MCR risk (HR 1.33, 95% CI 1.20-1.48). CMM is associated with an increased risk of MCR in older adults. Motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by slow gait speed and cognitive complaints.Cardiometabolic multimorbidity was associated with an increased MCR risk.An increased number of cardiometabolic diseases were dose-dependently associated with increased MCR risk.

Motoric cognitive risk syndrome and its association with falls: a secondary analysis of the Mexican Health and Aging Study

To reveal whether motoric cognitive risk syndrome (MCR) is associated with falls, recurrent falls, and complicated falls in older Mexican adults. This is a secondary analysis of the Mexican Health and Aging Study. MCR was assessed in 2012 and included fall-related outcomes (recurrent [≥2], complicated [need for medical treatment] and number) in the 2018 follow-up. Competing risks analysis was performed, and subhazard ratios (sHRs) were estimated, adjusting for different variables. Negative binomial regression was used to estimate the incidence rate ratio (IRR) of the number of falls. A total of 1 929 participants were included, with a median age of 62 years and 58.3% female. The prevalence of MCR was 17.4% and was associated with falls sHR 1.11 (95%CI: 1.11, 1.12), recurrent falls sHR 1.16 (95%CI: 1.15, 1.16) and complicated falls sHR 1.25 (95%CI: 1.24, 1.25). The number of falls was also independently associated with baseline MCR (IRR 1.19; 95% CI 1.01, 1.40; p=0.039). MCR is independently associated with falls. Increasing the evidence on how MCR anticipates burdensome problems in older adults could lead to actions to halt them; therefore, including it in screening assessments could be clinically useful.

Motoric Cognitive Risk Syndrome and Traffic Incidents in Older Drivers in Japan

To prevent motor vehicle collisions by older drivers, the increased risk of collisions should be considered early. Cognitive decline increases the risk of car collisions. Motoric cognitive risk syndrome (MCR), characterized by the presence of cognitive concerns and slow gait, can be assessed conveniently and is useful to assess the risk of dementia. To examine the association between MCR assessment findings and car collisions among older drivers in Japan. This cross-sectional study used data from a community-based cohort study, the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes, conducted in Japan from 2015 to 2018. Participants were community-dwelling older adults aged at least 65 years. Data were analyzed from February to March 2023. MCR was defined as having subjective memory concerns (SMC) and slow gait. Participants were classified into 4 groups: no SMC or slow gait, only SMC, only slow gait, and MCR. Participants were asked about the experience of car collisions during the last 2 years and near-miss traffic incidents during the previous year through face-to-face interviews. Odds of experiencing a collision or near-miss traffic incident were assessed using logistic regression. Among a total of 12 475 participants, the mean (SD) age was 72.6 (5.2) years, and 7093 (56.9%) were male. The group with only SMC and the group with MCR showed a higher proportion of both car collisions and near-miss traffic incidents than the other groups (adjusted standardized residuals > 1.96; P < .001). Logistic regression analysis showed the only SMC and MCR groups had increased odds of car collisions (only SMC group: odds ratio [OR], 1.48; 95% CI, 1.27-1.72; MCR group: OR, 1.73; 95% CI, 1.39-2.16) and near-miss traffic incidents (only SMC group: OR, 2.07; 95% CI, 1.91-2.25; MCR group: OR, 2.13; 95% CI, 1.85-2.45) after adjusting for confounding factors. After stratifying MCR assessments by objective cognitive impairment, significant associations were still observed. In the only slow gait group, objective cognitive impairment was associated with increased odds of car collisions (OR, 1.96; 95% CI, 1.17-3.28). In this cross-sectional study of community-dwelling older drivers in Japan, SMC and MCR were associated with car collisions and near-miss traffic incidents independent from objective cognitive impairment. Future studies should examine the mechanism of these associations in more detail.

Epidemiology of Motoric Cognitive Risk Syndrome in the Kerala Einstein Study: Protocol for a Prospective Cohort Study.

The southern India state of Kerala has among the highest proportion of older adults in its population in the country. An increase in chronic age-related diseases such as dementia is expected in the older Kerala population. Identifying older individuals early in the course of cognitive decline offers the best hope of introducing preventive measures early and planning management. However, the epidemiology and pathogenesis of predementia syndromes at the early stages of cognitive decline in older adults are not well established in India. The Kerala Einstein Study (KES) is a community-based cohort study that was established in 2008 and is based in the Kozhikode district in Kerala state. KES aims to establish risk factors and brain substrates of motoric cognitive risk syndrome (MCR), a predementia syndrome characterized by the presence of slow gait and subjective cognitive concerns in individuals without dementia or disability. This protocol describes the study design and procedures for this KES project. KES is proposing to enroll a sample of 1000 adults ≥60 years old from urban and rural areas in the Kozhikode district of Kerala state: 200 recruited in the previous phase of KES and 800 new participants to be recruited in this project. MCR is the cognitive phenotype of primary interest. The associations between previously established risk factors for dementia as well as novel risk factors (apathy and traumatic brain injury) and MCR will be examined in KES. Risk factor profiles for MCR will be compared between urban and rural residents as well as with individuals who meet the criteria for mild cognitive impairment (MCI). Cognitive and physical function, medical history and medications, sociodemographic characteristics, lifestyle patterns, and activities of daily living will be evaluated. Participants will also undergo magnetic resonance imaging and electrocardiogram investigations. Longitudinal follow-up is planned in a subset of participants as a prelude to future longitudinal studies. KES (2R01AG039330-07) was funded by the US National Institutes of Health in September 2019 and received approval from the Indian Medical Council of Research to start the study in June 2021. We had recruited 433 new participants from urban and rural sites in Kozhikode as of May 2023: 41.1% (178/433) women, 67.7% (293/433) rural residents, and 13.4% (58/433) MCR cases. Enrollment is actively ongoing at all the KES recruitment sites. KES will provide new insights into risk factors and brain substrates associated with MCR in India and will help guide future development of regionally specific preventive interventions for dementia. DERR1-10.2196/49933.

Can Social Participation Mediate the Motoric Cognitive Risk Syndrome, Depression &amp; Loneliness in Older Adults?

Abstract Date Presented 04/22/2023 In this study, we found the mediating role of social participation in the association of motoric cognitive risk (MCR) with depression of older adults. A social participation program to intervene with depression is recommended for older adults with MCR. Primary Author and Speaker: Jihyeun Park Additional Authors and Speakers: Suyeong Bae, Ji-Hyuk Park Contributing Authors: Ickpyo Hong, Sangmi Park, Jaehyu Jung, Sohyeon Yun, Anastassiya Khan

The Mediating Role of Social Participation in Motoric Cognitive Risk and its Relation to Depression and Loneliness in Older Adults.

Motoric cognitive risk syndrome (MCR) reduces the quality of life, independence, and social interaction in older adults. Social participation is a potentially modifiable factor that benefits cognitive and mental health. This study explored the mediating roles of social participation between MCR and depression and between MCR and loneliness. We performed a secondary analysis of data from the 2015-2016 National Social Life, Health, and Aging Project. Slow gait speed and cognitive decline were used to assess MCR. Mediation analysis was applied to two models, both of which used MCR as an exposure and social participation as a mediator. The outcomes were depression and loneliness for each model, respectively. Among 1,697 older adults, 196 (11.6%) had MCR. The mediating role of social participation was statistically significant in both models. The indirect effect (β=0.267, p=0.001) of MCR on depression through social participation comprised 11.97% of the total effect (β=2.231, p&lt;0.001). The indirect effect (β=0.098, p=0.001) of MCR on loneliness through social participation was 19.48% of the total effect (β=0.503, p&lt;0.001). Interventions to increase social participation may reduce depression and loneliness of older adults with MCR.

Association of Motoric Cognitive Risk Syndrome with Sarcopenia and Systemic Inflammation in Pre-Frail Older Adults.

Motoric cognitive risk syndrome (MCR) is defined by the presence of slow gait and subjective cognitive decline. It is well recognized as a prodrome for dementia, but the biological mechanism and trajectory for MCR are still lacking. The objective of this study was to explore the association of MCR with body composition, including sarcopenia and systemic inflammation, in pre-frail older adults in a cross-sectional study of 397 pre-frail community-dwelling older adults. Data on demographics, physical function, frailty, cognition (Montreal Cognitive Assessment (MoCA)), perceived health and depression were collected. Body composition was measured using a bioelectrical impedance analyzer. Systemic inflammatory biomarkers, such as progranulin, growth differentiation factor-15 (GDF-15), interleukin-10 (IL-10), interleukin-6 and tumor necrosis factor-α (TNF-α), were collected. Univariate and multivariate logistic regression were used to analyze the association between MCR, body composition, sarcopenia and systemic inflammatory biomarkers. The prevalence of MCR was 14.9%. They were significantly older and there were more females, depression, functional impairment, lower education, physical activity and MoCA scores. Body fat percentage (BF%), fat mass index, fat to fat free mass ratio (FM/FFM) and sarcopenia prevalence were significantly higher in MCR. Serum GDF-15 and TNF-α levels were highest with progranulin/TNF-α and IL-10/TNF-α ratio lowest in MCR. Compared to healthy patients, MCR was significantly associated with sarcopenia (aOR 2.62; 95% CI 1.46-3.17), BF% (aOR 1.06; 95% CI 1.01-1.12), FMI (aOR 1.16; 95% CI 1.02-1.30) and FM/FFM (aOR 6.38; 95% CI 1.20-33.98). The association of IL-10 to TNF-α ratio (aOR 0.98, 95% CI 0.97-0.99) and IL-10 (aOR 2.22, 95% CI 0.05-0.98) with MCR were independent of sarcopenia and BF%. Longitudinal population studies are needed to understand the role of body fat indices and IL-10 in pre-frail older adults with MCR and trajectory to dementia.

Association between motoric cognitive risk syndrome and future falls among Chinese community-dwelling elderly: A nationwide cohort study.

Motoric Cognitive Risk syndrome (MCR), known as the predementia stage, is characterized by both subjective cognitive complaint (SCC) and slow gait. This study aimed to investigate the causal relationship between MCR, its components, and falls. Participants aged ≥ 60 years were selected from China Health and Retirement Longitudinal Study. SCC was determined by participants' responses to the question "How would you rate your memory at present?" with "poor" being the indicative answer. Slow gait was defined as one standard deviation or more below age- and gender-appropriate mean values of gait speed. MCR was identified when both SCC and slow gait were presented. Future falls were investigated by the question "have you fallen down during follow-up until wave 4 in 2018?" Logistic regression analysis was performed to test the longitudinal association of MCR, its components and future falls during the following 3 years. Of 3748 samples in this study, the prevalence of MCR, SCC, and slow gait was 5.92%, 33.06%, and 15.21%, respectively. MCR increased the risk of falls during the following 3 years by 66.7% compared to non-MCR after controlling for covariates. In the fully adjusted models, with the healthy group as reference, MCR (OR=1.519, 95%CI=1.086-2.126) and SCC (OR=1.241, 95%CI=1.018-1.513), but not slow gait, increased the risk of future falls. MCR independently predicts future falls risk in the following 3 years. Measuring MCR can be a pragmatic tool for early identification of falls risk.

Motoric cognitive risk syndrome-Setting the course for dementia prevention?

The predicted increase in adults with dementia will pose amajor challenge for the German healthcare system. To mitigate this challenge, the early detection of adults with an increased risk of dementia is crucial. In this context, the concept of motoric cognitive risk (MCR) syndrome has been introduced into the English literature but is currently relatively unknown in German-speaking countries. What are the characteristics and diagnostic criteria of MCR? What is the impact of MCR on health-related parameters? What is the current state of evidence regarding the risk factors and prevention of the MCR? We reviewed the English language literature concerning MCR, the associated risk factors, and protective factors, similarities or differences with the concept of mild cognitive impairment (MCI), and its influence on the central nervous system. The MCR syndrome is characterized by subjective cognitive impairment and aslower gait speed. Compared to healthy adults, adults with the MCR have ahigher risk of dementia, falls, and mortality. Modifiable risk factors provide astarting point for specific multimodal lifestyle-related preventive interventions. As MCR can be easily diagnosed in practical settings, it could become an important concept for the early detection of adults with an increased risk of dementia in German-speaking countries, although further research is necessary to empirically confirm this assumption.

Association of Handgrip Strength Weakness and Asymmetry With Incidence of Motoric Cognitive Risk Syndrome in the China Health and Retirement Longitudinal Study.

Motoric cognitive risk (MCR) syndrome is a type of pre-dementia. It is defined as the co-occurrence of subjective cognitive complaints and a slow gait speed. A recent study found that handgrip strength (HGS) asymmetry is associated with an increased risk of neurodegenerative disorders. We aimed to investigate the associations of HGS weakness and asymmetry separately and together with MCR incidence among older Chinese adults. Data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study were used. HGS values <28 kg for male participants and <18 kg for female participants were considered HGS weaknesses. HGS asymmetry was assessed by the ratio of nondominant to dominant HGS. We used 3 different cutoff values of HGS ratio to define asymmetry, including 10%, 20%, and 30%. Specifically, HGS ratios <0.90 or >1.10 (10%), <0.80 or >1.20 (20%), and <0.70 or >1.30 (30%) were classified as asymmetry. The participants were classified into 4 groups: neither weakness nor asymmetry (neither), asymmetry only, weakness only, and weakness and asymmetry (both). The association between baseline HGS status and 4-year incidence of MCR was examined using logistic regression analyses. A total of 3,777 participants 60 years and older were included in the baseline analysis. The prevalence of MCR at the baseline was 12.8%. Participants with asymmetry only, weakness only, and both showed significantly increased risk of MCR. After excluding participants with MCR at baseline, 2,328 participants were included in the longitudinal analysis. There were 111 MCR cases (4.77%) over the 4-year follow-up period. Participants with HGS weakness and asymmetry together at baseline had increased odds of incident MCR (HGS ratio at 10%: odds ratio [OR] 4.48, p < 0.001; HGS ratio at 20%: OR 5.43, p < 0.001; HGS ratio at 30%: OR 6.02, p < 0.001). These results show that the presence of both HGS asymmetry and weakness is associated with MCR incidence. The early recognition of HGS asymmetry and weakness may be helpful in the prevention and treatment of cognitive dysfunction.

Association between positive control in self-perceptions of aging and motoric cognitive risk syndrome among Chinese community-dwelling older adults: a cross-sectional study

BackgroundSelf-perceptions of aging (SPA) are important psychosocial factors that lead to a wide range of outcomes including dementia. However, the relationships between positive SPA and motoric cognitive risk syndrome (MCR) which is a predementia syndrome are still unknown. This study aimed to reveal the associations of positive control and aging awareness of SPA with the risk of MCR and its components.MethodsA cross-sectional design was conducted among 1137 Chinese community-dwelling older adults. Positive control and aging awareness were defined by two dimensions of SPA (Positive control and Timeline chronic). MCR was determined according to definition. Multivariable logistic regression was used to examine the associations.ResultsThe overall prevalence of MCR was 11.5% (mean age = 71.62 ± 5.22). After adjusting for depression, anxiety, and cognitive function, positive control was associated with reduced risk of MCR (OR = 0.624, 95% CI 0.402–0.969, P = 0.036), subjective cognitive complaints (SCC) (OR = 0.687, 95% CI 0.492–0.959, P = 0.027), and gait speed (GS) (OR = 0.377, 95% CI 0.197–0.720, P = 0.003), respectively. Aging awareness was merely related to increased risk of MCR (OR = 1.386, 95% CI 1.062–1.810, P = 0.016).ConclusionsThis study highlights the crucial associations of positive control and aging awareness with MCR and its components. Our results emphasize that positive belief in control and adaptive aging awareness might be promising targets for preventing MCR.

Social isolation, loneliness, and motoric cognitive risk syndrome among older adults in China: A longitudinal study

This study aimed to investigate the associations between social isolation, loneliness, and motoric cognitive risk syndrome (MCR) among older adults in China. Data were obtained from the China Health and Retirement Longitudinal Study in the 2011 and 2015 waves. Social isolation and loneliness were measured by an index and an item, and MCR was defined as subjective cognitive complaints and slow gait. Multivariable logistic regression analyses were performed to examine the associations between social isolation, loneliness, and MCR by gender. Of 3251 eligible participants, the incidence of MCR was 10.03%. Social isolation and loneliness were not significantly associated with incident MCR in men. Loneliness was positively associated with incident MCR in women (OR: 1.45, 95% CI: 1.05, 2.01), while social isolation was not. Loneliness is associated with incident MCR among female older adults in China. More attention is advised to be paid to loneliness among female older adults, to hold promise for the prevention and reduction of MCR.

Motoric Cognitive Risk Syndrome and Cognitive Frailty

Motoric cognitive risk (MCR) syndrome and cognitive frailty (CF) are relatively new predementia syndromes that represent changes from baseline cognition that may be reversible or nonprogressive. Rehabilitation therapists may be the first clinicians to identify the symptoms of MCR syndrome and CF, of subjective cognitive complaints with the associated gait or strength impairments. Adopting screening tools in clinical practice and health screening events may help to identify these syndromes early and provide the opportunity for medical and lifestyle interventions to potentially minimize progression.

38 Plasma proteomic signature of motoric cognitive risk syndrome

OBJECTIVES/GOALS: Motoric cognitive risk (MCR) is a pre-dementia syndrome characterized by slow gait and subjective cognitive complaints. In the Atherosclerosis Risk in Communities (ARIC) study, we aim to (1) identify plasma proteins and protein modules associated with MCR and (2) compare the proteomic signature of MCR to that of mild cognitive impairment (MCI). METHODS/STUDY POPULATION: Nondemented ARIC participants were classified by MCR status (yes/no) according to a memory questionnaire and 4-meter walk. MCI status (yes/no) was classified by expert diagnosis using standardized criteria. We measured 4,877 proteins in plasma collected at ARIC Visit 5 (late-life) and Visit 2 (midlife) utilizing the SomaScan4 proteomic assay. Multivariable logistic regression”adjusted for demographic variables, kidney function, cardiovascular risk factors, and APOE4 status”related each protein to MCR at late-life. An FDR corrected P RESULTS/ANTICIPATED RESULTS: Proteome-wide association study among 4076 ARIC participants (mean age=75; 58% women, 17% Black, 4% MCR+, 21% MCI+; MCR+ and MCI+ groups overlapped) at late-life identified 26 MCR-associated proteins involved in metabolism, vascular/visceral smooth muscle, and extracellular matrix organization. At an uncorrected P DISCUSSION/SIGNIFICANCE: This proteomic characterization of MCR identifies novel plasma proteins and networks, both distinct from and overlapping with those of MCI, thus highlighting the partially divergent mechanisms underlying these pre-dementia syndromes. These findings may be leveraged toward dementia prognostication and targeted therapeutic approaches.

Biological Age Acceleration and Motoric Cognitive Risk Syndrome.

Motoric cognitive risk (MCR) syndrome, a predementia syndrome characterized by slow gait and subjective cognitive concerns, is associated with multiple age-related risk factors. We hypothesized that MCR is associated with biological age acceleration. We examined the associations of biological age acceleration with MCR, and mortality risk in MCR cases. Biological age was determined using proteomic and epigenetic clocks in participants aged 65 years and older in the LonGenity study (N=700, females=57.9%) and Health and Retirement Study (HRS; N=1,043, females=57.1%) cohorts. Age acceleration (AgeAccel) was operationally defined as the residual from regressing predicted biological age (from both clocks separately) on chronological age. Association of AgeAccel with incident MCR in the overall sample as well as with mortality risk in MCR cases was examined using Cox models and reported as hazard ratios (HRs). AgeAccel scores derived from a proteomic clock were associated with prevalent MCR (odds ratio adjusted for age, gender, education years, and chronic illnesses [aOR] = 1.36, 95% confidence interval [CI] = 1.09-1.71) as well as predicted incident MCR (HR=1.19, 95% CI=1.00-1.41) in the LonGenity cohort. In HRS, the association of AgeAccel using an epigenetic clock with prevalent MCR was confirmed (aOR=1.47, 95% CI=1.16-1.85). Participants with MCR and accelerated aging (positive AgeAccel score) were at the highest risk for mortality in both LonGenity (HR=3.38, 95% CI=2.01-5.69) and HRS (HR=2.47, 95% CI=1.20-5.10). Accelerated aging predicts risk for MCR, and is associated with higher mortality in MCR patients. ANN NEUROL 2023;93:1187-1197.

Chronic pain increases the risk of motoric cognitive risk syndrome at 4 years of follow-up: evidence from the China Health and Retirement Longitudinal Study.

Slower gait speed and subjective cognitive concerns are characteristics of the motoric cognitive risk (MCR) syndrome. This study aimed to examine if changes in pain may be hallmarks of early MCR, through investigating the magnitude of the association of chronic pain and the risk of MCR at 4 years follow-up. In total, 3711 participants without dementia or any mobility disability aged ≥60 years were studied, including 1413 with chronic pain, enrolled in the China Health and Retirement Longitudinal Study, a prospective cohort study. MCR assessed at wave 1 (2011) and wave 3 (2015) was used as the exposure. Cox regression analysis was used to examine the longitudinal association between chronic pain and MCR after adjusting for individual factors, behaviors/physiology factors and societal factors. Four years later, the incident MCR was evaluated. After adjusting for individual factors, chronic pain was found to increase the risk of MCR development over time by about 1.5 times (hazard ratio 1.562, 95% confidence interval 1.228-1.986; p < 0.001) and to be linked with incident MCR at baseline (odds ratio 1.397, 95% confidence interval 1.149-1.698; p < 0.001). These associations remained substantial when behaviors/physiology factors and societal factors were taken into account in the analytical models. The findings of our study imply that incident MCR may be exacerbated by chronic pain. Further exploration is required to find out whether chronic pain is a modifiable risk factor for MCR.

New onset, transient and stable motoric cognitive risk syndrome: Clinical characteristics and association with incidence of probable dementia in the NuAge cohort.

BackgroundMotoric cognitive risk syndrome (MCR) is a pre-dementia stage. The existence of stable and transient MCR, their related clinical characteristics and their association with incident dementia is a matter of debate.ObjectiveThis study aims to examine the clinical characteristics and the time course associated with new onset, transient and stable MCR, and their association with incidence of probable dementia in community-dwelling older adults living in the province of Quebec (Canada).DesignQuebec elderly population-based observational cohort study with 3 years of follow-up.SettingCommunity dwellers.SubjectsA subset of participants (n = 1,113) from the “Quebec Longitudinal Study on Nutrition and Successful Aging” (NuAge) cohort.MethodsParticipants with MCR were identified at baseline and after 1 year of follow-up. Socio-demographic characteristics, 30-item Geriatric depression scale (GDS) score, cardiovascular risk factors and diseases were recorded at baseline. Incidence of probable dementia was measured at annual follow-up visits over a 3-year period.ResultsOver the period of the first year of follow-up, the prevalence of MCR was 8.5% with 4.3% having new onset MCR, 2.8% transient MCR and 1.4% stable MCR. A higher 30-item GDS score was reported with new onset and transient MCR, and the highest prevalence of cerebrovascular diseases was shown with stable MCR compared to non-MCR participants (p &amp;lt; 0.05). MCR was associated with overall incidence of probable dementia, regardless of its status (Hazard Ratio ≥ 1.86, p ≤ 0.034).ConclusionGreater prevalence of depressive symptoms and cerebrovascular diseases were reported, respectively, with new onset and transient MCR, and stable MCR. The association of MCR with incidence of probable dementia remains significant, regardless of MCR subtypes.

Deep Neural Network-based Video Processing to Obtain Upper-Extremity Motor Performance Toward Assessment of Cognitive and Motor Function.

Dementia is an increasing global health challenge. Motoric Cognitive Risk Syndrome (MCR) is a predementia stage that can be used to predict future occurrence of dementia. Traditionally, gait speed and subjective memory complaints are used to identify old adults with MCR. Our previous studies indicated that dual-task upper-extremity motor performance (DTUEMP) quantified by a single wrist-worn sensor was correlated with both motor and cognitive function. Therefore, the DTUEMP had a potential to be used in the diagnosis of MCR. Instead of using inertial sensors to capture kinematic data of upper-extremity movements, here we proposed a deep neural network-based video processing model to obtain DTUEMP metrics from a 20-second repetitive elbow flexion-extension test under dual-task condition. In details, we used a deep residual neural network to obtain joint coordinate set of the elbow and wrist in each frame, and then used optical flow method to correct the joint coordinates generated by the neural network. The coordinate sets of all frames in a video recording are used to generate angle sequence which represents rotation angle of the line between the wrist and elbow. Then, the DTUEMP metrics (the mean and SD of flexion and extension phase) are derived from angle sequence. Multi-task learning (MTL) is used to assess cognitive and motor function represented by MMSE and TUG scores based on DTUEMP metrics, with single-task learning (STL) linear model as a benchmark. The results showed a good agreement (r ≥ 0.80 and ICC ≥ 0.58) between the derived DTUEMP metrics from our proposed model and the ones from clinically validated sensor processing model. We also found that there were correlations with statistical significance (p < 0.05) between some of video-derived DTUEMP metrics (i.e. the mean of flexion time and extension time) and clinical cognitive scale (Mini-Mental State Examination, MMSE). Additionally, some of video-derived DTUEMP metrics (i.e. the mean and standard deviation of flexion time and extension time) was also associated with the scores of timed-up and go (TUG) which is a gold standard to measure functional mobility. Mean absolute percentage error (MAPE) of MTL surpassed that of STL (For MMSE, MTL: 18.63%, STL: 23.18%. For TUG, MTL: 17.88%, STL: 22.53%). The experiments with different light conditions and shot angles verified the robustness of our proposed video processing model to extract DTUEMP metrics in potentially various home environments (r ≥ 0.58 and ICC ≥ 0.71). This study shows possibility of replacing sensor processing model with video processing model for analyzing the DTUEMP and a promising future to adjuvant diagnosis of MCR via a mobile platform.

PS-B10-11: PATHOPHYSIOLOGICAL STUDY OF COGNITIVE FRAILTY USING A MOUSE MODEL OF ALZHEIMER'S DISEASE

Objective: Hypertension is known to increase the risk of developing dementia including Alzheimer's disease (AD). The concept of cognitive frailty or motoric cognitive risk syndrome, representing a coexistence of physical and cognitive decline, has been attracting attention in the global aging society. However, the molecular mechanisms underlying the pathological interplay between these conditions remain largely unknown. Methods: We investigated the effects of AD pathogenesis on skeletal muscle by using APP23 mice, a mouse model of AD. Three-month-old male APP23 mice and wild-type mice from the same litter were evaluated for skeletal muscle function by grip strength, for cognitive function by passive avoidance and open field tests, and for glucose tolerance and 24-hour voluntary locomotion using a running wheel as factors related to both skeletal muscle function and cognitive function. After dissection, various organs, mainly skeletal muscle, were harvested and wet weight was evaluated. Results: Grip strength and some skeletal muscle weights of APP23 mice were lower than those of wild-type mice. The ipGTT was used to assess glucose tolerance, and the passive avoidance test and open field test were used to assess cognitive function, but there were no significant differences between genotypes. In the running wheel test, which measures voluntary locomotion, APP23 mice were significantly more active than wild-type mice suggesting that the muscle weakness in APP23 mice was not due to disuse. Conclusions: This study demonstrates that APP23 mice exhibit skeletal muscle deficits, including muscle weakness, along with cognitive dysfunction. In addition, APP23 mice showed behavioral abnormalities such as increased voluntary locomotion, which should contribute to increased skeletal muscle function, but skeletal muscle function was conversely decreased, suggesting that the effect of AD on skeletal muscle function is mediated by factors other than behavioral abnormalities due to cognitive dysfunction.

Motoric cognitive risk syndrome trajectories and incident dementia over 10 years

BackgroundMotoric Cognitive Risk (MCR) syndrome is a high-risk state for adverse health outcomes in older adults characterised by measured slow gait speed and self-reported cognitive complaints. The recent addition to the Lothian Birth Cohort 1936 of robust dementia outcomes enabled us to assess the prognostic value of MCR for dementia and explore the various trajectories of participants diagnosed with MCR. MethodsWe classified 680 community-dwelling participants free from dementia into non-MCR or MCR groups at mean [SD] age 76.3 [0.8] years. We used Cox and competing risk regression methods, adjusted for potential confounders, to evaluate the risk of developing all-cause incident dementia over 10 years of follow-up. Secondarily, we followed the trajectories for individuals with and without MCR at baseline and categorised them into subgroups based on whether MCR was still present at the next research wave, three years later. ResultsThe presence of MCR increased the risk of incident dementia (adjusted HR 2.34, 95%CI 1.14–4.78, p = 0.020), as did fewer years of education and higher depression symptoms. However, MCR has a heterogenous progression trajectory. The MCR progression subgroups each have different prognostic values for incident dementia. ConclusionMCR showed similar prognostic ability for dementia in a Scottish cohort as for other populations. MCR could identify a target group for early interventions of modifiable risk factors to prevent incident dementia. This study illustrates the heterogeneous nature of MCR progression. Exploring the underlying reasons will be important work in future work.