Prevalence Of Motoric Cognitive Risk Syndrome Research Articles

FC45: Clinical profiles for motoric cognitive risk syndrome in rural-dwelling older adults: the MIND-China study

Objective:Motoric cognitive risk syndrome (MCR), which is defined as a pre-dementia syndrome characterized by subjective cognitive complaints and slow gait in older individuals free of dementia and mobility disability, has been associated with increased risks of dementia, functional dependence, and mortality. The aims of this study were to describe the prevalence and distribution of MCR and to explore the clinical profiles associated with MCR in rural-dwelling older adults.Methods:The population-based cross-sectional study included 5,021 dementia- and disability-free participants (age ≥60 years; 56.48% women) in the baseline assessments (March-September 2018) of the Multimodal Interventions to delay Dementia and disability in rural China (MIND-China). The MCR syndrome was diagnosed when the participants had subjective memory complaints and gait speed ≥1 standard deviation (SD) below the age- (<75 and ≥75 years) and sex-specific means. We estimated the age- and sex-specific prevalence of MCR. We used logistic regression models to examine lifestyle and clinical factors associated with MCR while controlling for age, sex, and education.Results:The overall prevalence of MCR syndrome was 13.58%, with the prevalence being 11.53% in males and 15.16% in females (P<0.001). The prevalence of MCR was increased with age, from 10.43% in people aged 60-69 years and 15.97% in those aged 70-79 years to 21.71% among those aged ≥80 years. The demographic-adjusted odds ratio (95% confidence interval) of MCR was 1.30 (1.08-1.57) for being overweight (body mass index 24-27.9 vs. <24 kg/m2), 1.65 (1.32-2.05) for having obesity (≥28 kg/m2), 1.74 (1.41-2.15) for diabetes, 1.44 (1.20-1.73) for dyslipidemia, 1.59 (1.32-1.91) for having coronary heart disease, 2.17 (1.78-2.65) for having stroke history, 1.52 (1.24-1.86) for having osteoarthritis, and 3.40 (2.70-4.28) for having depressive symptoms. Ever (vs. never) smoking and alcohol consumption were related to odds ratio of 0.65 (0.48-0.86) and 0.71 (0.55-0.91), respectively, for MCR syndrome.Conclusion:The MCR syndrome affects nearly 1 in 7 Chinese rural older adults, and the MCR prevalence appears to be higher in women than in men. Cardiometabolic risk factors (e.g., overweight/obesity, diabetes, and dyslipidemia), osteoarthritis, coronary heart disease, stroke, and depressive symptoms were associated with increased likelihoods of the MCR syndrome.

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.

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.

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.

Motoric cognitive risk syndrome and incident hospitalization in Quebec's older population: Results of the NuAge cohort study.

BackgroundScreening older adults at risk of hospitalization is essential to prevention of this adverse event. Motoric cognitive risk syndrome (MCR) has been associated with incident dementia and falls, which are both risk factors of hospitalization. There is no information on the association of MCR with incident hospitalization in older adults.ObjectiveThe study aims to examine the association of MCR with incident hospitalization in community-dwelling older adults.DesignQuebec older population-based observational cohort study with 3 years of follow-up.SettingCommunity dwellings.SubjectsA subset of 999 participants recruited in the NuAge study.MethodsParticipants with MCR (i.e., with slow gait and cognitive complaint without dementia or motor disability) were identified at baseline assessment. Incident hospitalization (i.e., ≥1) and its recurrence (i.e., ≥2) were collected annually over a 3 year follow-up period.ResultsThe prevalence of MCR was 5.0% at baseline. The overall incidence of hospitalization was 29.0% and its recurrence 4.8%. MCR was associated with incident recurrent hospitalization [adjusted Hazard Ratio (aHR) = 2.58 with 95% Confidence Interval (CI) = (1.09–6.09) and P = 0.031], but not with incident hospitalization [aHR = 1.48, with 95%CI = (0.95–2.28) and P = 0.081].ConclusionMCR is associated with incident recurrent hospitalization in NuAge participants, suggesting that MCR may be of clinical interest for screening individuals at risk for hospitalization in Quebec's older population.

Association between depression and motoric cognitive risk syndrome among community-dwelling older adults in China: A4-year prospective cohort study.

Depression can lead to a wide range of adverse health outcomes, including dementia. However, evidence supporting the relationship between depression and motoric cognitive risk syndrome (MCR), a pre-dementia syndrome, remains lacking. This study aimed to examine the association between depression and MCR among community-dwelling Chinese older adults. Data were taken from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Depression was defined by a Center for Epidemiological Studies Depression Scale (CES-D) score ≥10. MCR was defined as subjective cognitive complaints and objective slow gait speed. Multivariate logistic regression analyses were conducted to examine the cross-sectional and longitudinal associations between depression and MCR at baseline and a 4-year follow-up period for the sample population and gender groups. The prevalence of MCR was higher in participants with depression than in those without depression at baseline (12.2% vs. 8.9%; p=0.001). Participants with depression at baseline had a higher 4-year incidence of MCR than those without depression (14.8% vs. 8.7%; p<0.001). Both cross-sectional analysis (odds ratio [OR]1.41, 95% confidence interval [CI] 1.13-1.75) and prospective analysis (OR1.95, 95% CI 1.56-2.44) demonstrated that depression was significantly associated with MCR. These associations were consistent across different gender groups and stronger among female individuals. Depression is an independent risk factor for MCR among community-dwelling Chinese older adults. Special attention should be paid to the care of older people with depression to reduce the occurrence of MCR and even dementia.

Walking While Talking and Prefrontal Oxygenation in Motoric Cognitive Risk Syndrome: Clinical and Pathophysiological Aspects.

Motoric cognitive risk syndrome (MCR) combines slow gait and cognitive complaints and has been proposed as a predementia syndrome. The nature of dual-task performance in MCR has not been established. To assess differences in dual-task performance between participants with and without MCR and to study the prefrontal cortex (PFC)-based brain activity during dual-task using functional near-infrared spectroscopy. Cohort study of community-dwelling non-demented older adults included in the "Central Control of Mobility in Aging" study. Comprehensive assessment included global cognition and executive function tests along with clinical variables. Dual-task paradigm consisted in walking while reciting alternate letters of the alphabet (WWT) on an electronic walkway. We compared dual-task performance between MCR (n = 60) and No MCR (n = 478) participants and assessed the relationship of dual-task performance with cognitive function. In a subsample, we compared PFC oxygenation during WWT between MCR (n = 32) and No MCR (n = 293). In our sample of 538 high-functioning older adults (76.6±6.5 years), with 11.2% prevalence of MCR, dual-task cost was not significantly different, compared to No MCR participants. Among MCR participants, no significant relationship was found between WWT velocity and cognitive function, whereas No MCR participants with better cognitive function showed faster WWT velocities. PFC oxygenation during WWT was higher in MCR compared to No MCR (1.02±1.25 versus 0.66±0.83, p = 0.03). MCR participants showed no significant differences in the dual-task cost while exhibiting higher PFC oxygenation during dual-task walking. The dual-task performance (WWT velocity) in MCR participants was not related to cognition.

Motoric cognitive risk syndrome and incident dementia in older adults from the Québec NuAge cohort.

The co-occurrence of slow walking speed and subjective cognitive complaint (SCC) in non-demented individuals defines motoric cognitive risk syndrome (MCR), which is a pre-dementia stage. There is no information on the association between MCR and incident dementia in Québec's older population. The study aims to examine the association of MCR and its individual components (i.e. SCC and slow walking speed) with incident dementia in community-dwelling older adults living in the province of Québec (Canada). Québec older people population-based observational cohort study with 3years of follow-up. Community dwellings. A subset of participants (n = 1,098) in 'Nutrition as a determinant of successful aging: The Québec longitudinal study' (NuAge). At baseline, participants with MCR were identified. Incident dementia was measured at annual follow-up visits using the Modified Mini-Mental State (≤79/100) test and Instrumental Activity Daily Living scale (≤6/8) score values. The prevalence of MCR was 4.2% at baseline and the overall incidence of dementia was 3.6%. MCR (Hazard Ratio (HR) = 5.18, with 95% confidence interval (CI) = [2.43-11.03] and P ≤ 0.001) and SCC alone (HR = 2.54, with 95% CI = [1.33-4.85] and P = 0.005) were associated with incident dementia, but slow walking speed was not (HR = 0.81, with 95%CI = [0.25-2.63] and P = 0.736). MCR and SCC are associated with incident dementia in NuAge study participants.

The association of anxio-depressive disorders and depression with motoric cognitive risk syndrome: results from the baseline assessment of the Canadian longitudinal study on aging.

Motoric cognitive risk syndrome (MCR), anxio-depressive disorders (ADD), and depression are associated with cognitive complaint and slow gait speed. The study aims to examine (1) the association of ADD and depression with MCR, and (2) the influence of the type and the severity of ADD and age on this association in older adults. A total of 29,569 participants free from cognitive impairmentwith walking speed measure recruited at baseline in the Canadian Longitudinal Study on Aging (CLSA) Comprehensive were selected in this cross-sectional study. They were separated into different sub-groups based on their age groups (i.e., 45-54, 55-64, 65-74, and ≥ 75) and the presence of MCR. Anxiety, mood, and depressive disorders (ADD) were assessed. Depression was defined by the Center for Epidemiological Studies Depression Scale (CES-D) score ≥ 10. The overall prevalence of MCR was 7.0% and was greater in the youngest age group (8.9%) as compared to the other age groups (P < 0.05). There was a higher prevalence of ADD and depression in individuals with MCR compared to those without MCR for all age groups (P ≤ 0.001). Depression was significantly associated with MCR regardless of age group (odds ratio ≥ 3.65 with P ≤ 0.001). The association of ADD with MCR depended on the accumulation of disorders and not their type, and was weaker and more inconstant in the oldest age group as compared to younger age groups. MCR is associated with ADD and depression in both younger and older individuals. This association is stronger for depression in younger individuals.

Association of Motoric Cognitive Risk Syndrome with Cardiovascular Disease and Risk Factors: Results from an Original Study and Meta-Analysis.

Motoric cognitive risk (MCR) syndrome, a recently described pre-dementia syndrome, has been associated with cardiovascular disease and their risk factors (CVDRF). To determine whether MCR syndrome was associated with CVDRF in French community-dwelling older adults, and to quantitatively evaluate, with a systematic review and meta-analysis, the association of MCR syndrome with CVDRF. Based on a cross-sectional design, 238 older adults without dementia were selected from the French GAIT study. An English and French systematic Medline and Embase search (without limiting date of publication) was also conducted in February 2017 using the terms "motoric cognitive risk syndrome" OR "motoric cognitive risk" OR "motoric risk". The systematic review and meta-analysis included 8 studies. CVDRF were defined as cardiovascular diseases, hypertension, diabetes, stroke, obesity and abnormal waist-hip ratio (WHR). The prevalence of MCR syndrome in the current original study was 16.8%. MCR syndrome was associated with abnormalWHR(Odds ratio [OR] >2.8 with p < 0.020) and high blood pressure (OR >2.5 with p < 0.025). Of the 202 originally identified abstracts, 7 (3.5%) were selected for the systematic review. The meta-analysis showed that all pooled OR were significant with a p-value <0.001 (OR = 1.41 for cardiovascular diseases, 1.21 for hypertension, 1.44 for diabetes, 2.05 for stroke, and 1.34 for obesity). When pooling all CVDRF, the overall OR was 1.38 (95% CI, 1.33-1.45) with p-value <0.001. MCR syndrome is significantly associated with CVDRF. These findings suggest that a vascular mechanism may underlie the pathophysiology of MCR syndrome.