Motoric cognitive risk syndrome and the risk of dementia

J Gerontol A Biol Sci Med Sci. 2013 Apr;68(4):412-8. doi: 10.1093/gerona/gls191. Epub 2012 Sep 17.

Abstract

Background: Despite growing evidence of links between gait and cognition in aging, cognitive risk assessments that incorporate motoric signs have not been examined. We sought to validate a new Motoric Cognitive Risk (MCR) syndrome to identify individuals at high risk of developing dementia.

Methods: We evaluated 997 community residing individuals aged 70 and older participating in the Einstein Aging Study over a median follow-up time of 36.9 months. MCR syndrome was defined as presence of cognitive complaints and slow gait (one standard deviation below age- and sex-specific gait speed means) in nondemented individuals. Cox models were used to evaluate the effect of MCR syndrome on the risk of developing dementia and subtypes.

Results: Fifty-two participants met criteria for MCR syndrome at baseline with a prevalence of 7% (95% CI: 5-9%). Prevalence of MCR increased with age. Participants with MCR were at higher risk of developing dementia (hazard ratio [HR] adjusted for age, sex, and education: 3.27, 95% CI: 1.55-6.90) and vascular dementia (adjusted HR: 12.81, 95% CI: 4.98-32.97). The association of MCR with risk of dementia or vascular dementia remained significant even after accounting for other confounders and diagnostic overlap with "cognitive" mild cognitive impairment syndrome subtypes.

Conclusions: A motor-based MCR syndrome provides a clinical approach to identify individuals at high risk for dementia, especially vascular dementia, to target for further investigations and who may benefit from preventive interventions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cognition Disorders* / complications
  • Cognition Disorders* / diagnosis
  • Cognition Disorders* / epidemiology
  • Cognition Disorders* / physiopathology
  • Dementia* / classification
  • Dementia* / etiology
  • Dementia* / prevention & control
  • Early Diagnosis
  • Female
  • Gait
  • Humans
  • Intelligence Tests*
  • Male
  • Neuropsychological Tests*
  • Prevalence
  • Proportional Hazards Models
  • Psychomotor Disorders* / complications
  • Psychomotor Disorders* / diagnosis
  • Psychomotor Disorders* / epidemiology
  • Psychomotor Disorders* / physiopathology
  • Reproducibility of Results
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Risk Factors
  • Sex Factors
  • Syndrome