Association Between Motoric Cognitive Risk Syndrome and Risk of Mortality in Older Adults: Results of a 5-year Retrospective Cohort

Pajuelo-Vasquez, Renzo; Ramirez, Luis Fernando Pajares; Gutierrez-Baca, Wendy; Ocón, Víctor Oswaldo Calderón; Bernuy, Mauricio Enrique Grande; Parodi, José F.; Runzer-Colmenares, Fernando M.

doi:10.1007/s12126-022-09508-3

Cited by 5 publications

(7 citation statements)

References 43 publications

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“…Among five different studies, comprising 25,598 participants from seven cohorts, MCR was found to be linked with an increased risk of mortality. All seven cohorts provided the adjusted HRs [12, 15, 38, 46]. The pooled RRs of seven cohorts were 1.66 (95% CI = 1.32–2.10, shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Since heterogeneity was high ( I 2 = 73%, p = 0.001), a random-effects model was employed. Subgroup analyses were not possible due to the limited retrospective cohort study to identify the sources of heterogeneity [46]. After excluding studies on the prediction of mortality by MCR in the EPIDémiologie de l’OStéoporose (EPIDOS) cohort [38], a sensitivity analysis was performed in this study and indicated that the heterogeneity disappeared ( I 2 = 0%, p = 0.52, shown in Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Four cross-sectional [23,[28][29][30], eleven longitudinal studies [5,7,8,11,15,26,[31][32][33][34][35], and seventeen cohort studies [12,16,24,25,27,[36][37][38][39][40][41][42][43][44][45][46][47] were included in the study, involving a total of 1,224,569 participants with study sample sizes ranging from 314 to 1,137,530 participants (see online suppl. Table 2).…”

Section: Study and Participants' Characteristicsmentioning

confidence: 99%

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Motoric Cognitive Risk Syndrome as a Predictor of Adverse Health Outcomes: A Systematic Review and Meta-Analysis

Huang,

Wu,

Zhang

et al. 2024

Gerontology

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Introduction: Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome characterized by subjective cognitive complaints (SCC) and slow gait (SG). Increasing evidence links MCR to several adverse health outcomes, but the specific relationship between MCR and the risk of frailty, Alzheimer’s disease (AD) and vascular dementia (VaD) remains unclear. Additionally, literature lacks analysis of MCR’s components and associated health outcomes, complicating risk identification. This systematic review and meta-analysis aim to provide a comprehensive overview of MCR’s predictive value for adverse health outcomes. Methods: Relevant cross-sectional, cohort, and longitudinal studies examining the association between MCR and adverse health outcomes were extracted from seven electronic databases. The Newcastle Ottawa Scale (NOS) and modified NOS were used to assess the risk of bias in studies included in the analysis. Relative ratios (RRs) and 95% confidence intervals (CIs) were pooled for outcomes associated with MCR. Results: Twenty-eight longitudinal or cohort studies and four cross-sectional studies with 1,224,569 participants were included in the final analysis. The risk of bias in all included studies was rated as low or moderate. Pooled analysis of RR indicated that MCR had a greater probability of increased the risk of dementia (adjusted RR=2.02; 95%CI=1.94-2.11), cognitive impairment (adjusted RR=1.72; 95%CI=1.49-1.99), falls (adjusted RR=1.32; 95%CI=1.17-1.50), mortality (adjusted RR=1.66; 95%CI=1.32-2.10); MCR had more prominent predictive efficacy for AD (adjusted RR=2.23; 95%CI=1.81-2.76) compared to VaD (adjusted RR=3.78; 95%CI=0.49-28.95), while excluding analyses from the study that utilized the Timed-up-and-go test and one-leg-standing to evaluate gait speed. One study examined the association between MCR and disability (HR=1.69; 95%CI=1.08-2.02) and frailty (OR=5.53; 95%CI=1.46-20.89). SG was a stronger predictor of the risk for dementia and falls than SCC (adjusted RR=1.22; 95%CI=1.11-1.34 vs. adjusted RR=1.19; 95%CI= 1.03-1.38). Conclusion: MCR increases the risk of developing any discussed adverse health outcomes and the predictive value for AD is superior to VaD. Additionally, SG is a stronger predictor of dementia and falls than SCC. Therefore, MCR should be routinely assessed among adults to prevent poor prognosis, and provide evidence to support future targeted interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study and Participants' Characteristicsmentioning

confidence: 99%

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Motoric Cognitive Risk Syndrome as a Predictor of Adverse Health Outcomes: A Systematic Review and Meta-Analysis

Huang,

Wu,

Zhang

et al. 2024

Gerontology

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“…Bidirectional associations of the cognitive domain with mobility ( 83 ) (cognitive motor syndrome ( 84 ), cognitive frailty) ( 85 ), sensory (visual ( 86 ) and hearing ( 87 )), psychological ( 88 ), and vitality ( 89 )(metabolism and nutrition) have been demonstrated. Likewise, the manifestations in different domains worsen the prognosis of active life and well-being ( 90 ). Detecting changes in any of these domains can help detect early and manage cognitive alterations that could materialize in AD or its risk factors ( 91 ).…”

Section: Resultsmentioning

confidence: 99%

A task force for diagnosis and treatment of people with Alzheimer’s disease in Latin America

Lopera,

Custodio,

Rico-Restrepo

et al. 2023

Front. Neurol.

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Alzheimer’s disease (AD) represents a substantial burden to patients, their caregivers, health systems, and society in Latin America and the Caribbean (LAC). This impact is exacerbated by limited access to diagnosis, specialized care, and therapies for AD within and among nations. The region has varied geographic, ethnic, cultural, and economic conditions, which create unique challenges to AD diagnosis and management. To address these issues, the Americas Health Foundation convened a panel of eight neurologists, geriatricians, and psychiatrists from Argentina, Brazil, Colombia, Ecuador, Guatemala, Mexico, and Peru who are experts in AD for a three-day virtual meeting to discuss best practices for AD diagnosis and treatment in LAC and create a manuscript offering recommendations to address identified barriers. In LAC, several barriers hamper diagnosing and treating people with dementia. These barriers include access to healthcare, fragmented healthcare systems, limited research funding, unstandardized diagnosis and treatment, genetic heterogeneity, and varying social determinants of health. Additional training for physicians and other healthcare workers at the primary care level, region-specific or adequately adapted cognitive tests, increased public healthcare insurance coverage of testing and treatment, and dedicated search strategies to detect populations with gene variants associated with AD are among the recommendations to improve the landscape of AD.

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“…Studies have shown that MCR prevalence varies from 2 to 18% in different countries (Congcong and Linping, 2021), with a pooled prevalence of 9.7% among individuals aged 60 and older across 17 countries (Verghese et al, 2014). MCR is linked to an increased risk of multiple falls (RR 1.77, 95% CI 1.25, 2.51) (Callisaya et al, 2016), incident dementia (Verghese et al, 2014;Beauchet et al, 2020), disability (Chhetri et al, 2017) and all-cause mortality (Bortone et al, 2022;Pajuelo-Vasquez et al, 2023). These findings highlight that MCR involves both cognitive and mobility impairments, posing challenges for families and healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

Enhancing predictive validity of motoric cognitive risk syndrome for incident dementia and all-cause mortality with handgrip strength: insights from a prospective cohort study

Bai,

Ma,

Yang

et al. 2024

Front. Aging Neurosci.

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BackgroundThis study aimed to assess whether integrating handgrip strength (HGS) into the concept of motoric cognitive risk (MCR) would enhance its predictive validity for incident dementia and all-cause mortality.MethodsA cohort of 5, 899 adults from the Health and Retirement Study underwent assessments of gait speed, subjective cognitive complaints, and HGS were involved. Over a 10-year follow-up, biennial cognitive tests and mortality data were collected. Cox proportional hazard analyses assessed the predictive power of MCR alone and MCR plus HGS for incident dementia and all-cause mortality.ResultsPatients with MCR and impaired HGS (MCR-HGS) showed the highest adjusted hazard ratios (AHR) for dementia (2.33; 95% CI, 1.49–3.65) and mortality (1.52; 95% CI, 1.07–2.17). Even patients with MCR and normal HGS (MCR-non-HGS) experienced a 1.77-fold increased risk of incident dementia; however, this association was not significant when adjusted for socioeconomic status, lifestyle factors, and medical conditions. Nevertheless, all MCR groups demonstrated increased risks of all-cause mortality. The inclusion of HGS in the MCR models significantly improved predictive discrimination for both incident dementia and all-cause mortality, as indicated by improvements in the C-statistic, integrated discrimination improvement (IDI) and net reclassification indices (NRI).ConclusionOur study underscores the incremental predictive value of adding HGS to the MCR concept for estimating risks of adverse health outcomes among older adults. A modified MCR, incorporating HGS, could serve as an effective screening tool during national health examinations for identifying individuals at risk of dementia and mortality.

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Association Between Motoric Cognitive Risk Syndrome and Risk of Mortality in Older Adults: Results of a 5-year Retrospective Cohort

Cited by 5 publications

References 43 publications

Motoric Cognitive Risk Syndrome as a Predictor of Adverse Health Outcomes: A Systematic Review and Meta-Analysis

Motoric Cognitive Risk Syndrome as a Predictor of Adverse Health Outcomes: A Systematic Review and Meta-Analysis

A task force for diagnosis and treatment of people with Alzheimer’s disease in Latin America

Enhancing predictive validity of motoric cognitive risk syndrome for incident dementia and all-cause mortality with handgrip strength: insights from a prospective cohort study

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