Functional mobility in older women with and without motoric cognitive risk syndrome: a quantitative assessment using wearable inertial sensors

Abstract

Background. The Motoric Cognitive Risk (MCR) syndrome is defined in non-demented older adults by cognitive complaints and slow gait. Individuals with MCR are at higher risk of dementia and other poor clinical outcomes, such as falls. However, no data are available as regards functional mobility alterations associated with MCR. The main purpose of the present study is to quantitatively investigate such an aspect using the instrumented Timed-Up-and-Go (iTUG) test carried out using a wearable inertial measurement unit (IMU). Methods. Fifty-one women aged over 65 years underwent a geriatric and neuropsychologic assessment (which included the Mini Mental State Examination, MMSE and Addenbrooke's Cognitive Examination Revised, ACE-R), instrumented gait analysis and iTUG performed using an IMU located on the lower back. Based on subjective cognitive complaints and slow gait, they were assigned either to the MCR (n = 24) or non-MCR (n = 27) group. IMU data allowed calculation of overall and sub-phases iTUG times. Results. Women with MCR were characterized by a significantly higher body mass and body mass index, lower normalized handgrip strength, and similar values of MMSE compared to non-MCRs. A trend was observed in terms of lower overall and sub-domain ACE-R score. They also performed iTUG at a significantly slower speed (22.4 s vs 14.1 of the non-MCR group, p < 0.001) and exhibited increased sub-phase times (29 to 31% higher with respect to non-MCRs). Conclusions. The findings of the present study suggest that the MCR syndrome impairs functional mobility, probably due reduced muscular strength and coordination, fear of falling and increased instability. The instrumental evaluation of functional mobility appears useful in the management of women with MCR, particularly in monitoring the progression of the motor impairments, verifying the effectiveness of interventions targeted in alleviating the impact on daily life of mobility limitations associated with MCR and in defining tailored rehabilitation programs.

Motoric Cognitive Risk Syndrome and Cognitive Frailty

“…49,63 Women with MCR syndrome trended toward lower instrumented TUG speeds (22.4 seconds vs 14.1 seconds) while the non-MCR group performed at increased times (∼30% higher). 64 The use of wearable devices measuring stride length, steadiness, and time in double support in addition to both single-and dual-task gait speeds provided an additional accuracy and was able to differentiate individuals with CF from healthy peers. 65 Grip strength is a key component of identifying physical frailty and CF.…”

“…Future options for assessing gait speed associated with MCR syndrome that require a laboratory may be through the utilization of quantitative gait analysis through instrumented walkways and wearable sensors for measuring spatial (stride length), temporal (support time), and spatiotemporal (cadence) parameters since the initial gait changes may be subtle 49,63. Women with MCR syndrome trended toward lower instrumented TUG speeds (22.4 seconds vs 14.1 seconds) while the non-MCR group performed at increased times (∼30% higher) 64. The use of wearable devices measuring stride length, steadiness, and time in double support in addition to both single- and dual-task gait speeds provided an additional accuracy and was able to differentiate individuals with CF from healthy peers 65…”