Motoric Cognitive Risk Syndrome in Polypharmacy

George, Claudene J.

doi:10.1111/jgs.16380

Cited by 16 publications

(10 citation statements)

References 20 publications

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“…Older people were considered to have SCD only when they felt they had more memory problems than most people. By contrast, participants were diagnosed with SCD when their self-perceived memory was either poor or worse than before in other researches [ 6 , 49 ]. An alternative explanation is that our study participants were relatively healthy community residents rather than outpatients or inpatients, which may underestimate the prevalence of MCR.…”

Section: Discussionmentioning

confidence: 84%

Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model

Zhang

et al. 2022

BMC Geriatr

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Background Sarcopenia has been identified as a risk factor for cognitive impairment, and motoric cognitive risk syndrome (MCR) is a recently defined pre-dementia syndrome. It is not known whether they are related. We aimed to investigate the association and potential pathways between sarcopenia and MCR in the community elderly by establishing a moderated mediation model. Methods 846 community residents aged ≥ 60 years were recruited from May 2021 to September 2021 and had a comprehensive geriatric evaluation. The diagnosis of sarcopenia followed the criteria issued by the Asian Working Group for Sarcopenia in 2019. MCR was defined as subjective cognitive decline and slow gait. Apathy symptoms and physical activity were assessed by the Apathy Evaluation Scale (AES) and the International Physical Activity Questionnaire (IPAQ). Logistic regression and moderated mediation analyses were conducted to explore the association between the four. Results 60 (7.1%) had MCR among 846 participants. After full adjustment, sarcopenia (odds ratio [OR] = 3.81, 95% confidence interval [CI] = 1.69–8.60, P = 0.001), AES score (OR = 1.09, 95% CI = 1.04–1.14, P < 0.001), and IPAQ level (OR = 0.43, 95% CI = 0.28–0.66, P < 0.001) were associated with MCR. Apathy partially mediated the relationship between sarcopenia and MCR. Physical activity played a moderation role in the indirect pathway of the mediation model. The increase in physical activity can alleviate the indirect effect of sarcopenia on MCR. Conclusion We established a moderated mediation model to uncover the underlying association mechanism of sarcopenia and MCR preliminarily. These findings suggest that attention should be paid to the management of apathy and physical activity in the context of sarcopenia to prevent early dementia actively. Further validation is needed in future longitudinal studies.

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Section: Discussionmentioning

confidence: 84%

Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model

Zhang

et al. 2022

BMC Geriatr

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“…Já em relação as diferenças na velocidade da marcha de idosos com e sem a SRCM, Ayers e Verghese 31 analisaram os parâmetros da marcha e detectaram que os idosos com a síndrome apresentaram menor comprimento da passada e menor tempo da fase de balanço quando comparados aos idosos sem a SRCM. Na comparação entre os grupos de idosos com e sem a SRCM, deste estudo, não houve diferenças significativas entre os grupos para as variáveis baixa escolaridade, presença de doenças crônicas, polifarmácia, excesso de peso e inatividade física, o que diverge dos achados de pesquisas anteriores que demonstraram diferenças significativas para a presença dessas variáveis entre os grupos 13,32 .…”

Section: Discussionunclassified

Síndrome de risco cognitivo motor em pessoas idosas de um serviço de saúde do Distrito Federal: estudo transversal

Moura

Pinheiro

2021

Rev. bras. geriatr. gerontol.

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Resumo Objetivo Verificar a prevalência da síndrome de risco cognitivo motor (SRCM) em pessoas idosas do Distrito Federal (DF), Brasil, que frequentaram os serviços de saúde de uma unidade de referência em Geriatria e Gerontologia, comparar os grupos de idosos com e sem a síndrome e investigar os possíveis fatores associados ao desenvolvimento dessa síndrome. Método Trata-se de estudo observacional transversal analítico, desenvolvido com idosos (idade ≥60 anos) com marcha independente e sem alterações cognitivas graves, que possuíam registro de dados sociodemográficos, avaliação cognitiva, capacidade funcional e velocidade de marcha em prontuários datados de 2017 a 2019. A análise dos dados foi expressa em média e desvio-padrão, frequência e percentual, e em odds ratios (OR) com intervalos de confiança de 95%. As comparações entre os grupos com e sem a SRCM foram feitas por meio dos testes: qui-quadrado, U de Mann-Whitney e t de Student. Resultados Não houve diferenças significativas na comparação das variáveis entre os grupos. A prevalência da SRCM na população estudada foi de 24%. Nenhum dos fatores analisados demonstrou associação com a presença da síndrome. Conclusão A prevalência da SRCM na amostra foi de 24% e mostrou-se mais alta na população do DF quando comparada as populações estudadas em outros países. Não houve diferenças entre os grupos de idosos com e sem a síndrome, e os fatores associados não foram encontrados. O rastreio da síndrome é de extrema relevância, pois a partir desses achados pode-se desenvolver mecanismos para a prevenção de demência em idosos.

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“…Polypharmacy, which involves the usage of five or more regularly scheduled medications, has also been considered as a modifiable risk factor for MCR. A study in a total of 1,119 adults (≥65 years) in a cross-sectional cohort of Community-based Health and Retirement Study showed that polypharmacy, that marked for the medical co-morbidities and complexities, related with decline in the gait velocity and cognitive loss as compared with the ones without polypharmacy (George and Verghese, 2020 ). Polypharmacy appended the chances of adverse drug events and interactions, intentional and non-intentional medical adherence, and reduced treatment effectiveness that increased MCR through the metabolic and structural alterations in the brain (George and Verghese, 2020 ).…”

Section: Pathologymentioning

confidence: 99%

Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery

Liu

Sun

2022

Front. Aging Neurosci.

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The motoric cognitive risk (MCR) syndrome is a pre-dementia condition, marked by the enhanced risk for Alzheimer's disease (AD) and vascular dementia, together with falls, disability, and abnormal movements. The research studies revealed the distinct neurological and non-neurological clinical gait irregularities during dementia and accelerated functional decline, such as postural and balance impairments, memory loss, cognitive failure, and metabolic dysfunctions. The disabling characteristics of MCR comprise altered afferent sensory and efferent motor responses, together with disrupted visual, vestibular, and proprioceptive components. The pathological basis of MCR relates with the frontal lacunar infarcts, white matter hyperintensity (WMH), gray matter atrophy in the pre-motor and pre-frontal cortex, abnormal cholinergic functioning, inflammatory responses, and genetic factors. Further, cerebrovascular lesions and cardiovascular disorders exacerbate the disease pathology. The diagnosis of MCR is carried out through neuropsychological tests, biomarker assays, imaging studies, questionnaire-based evaluation, and motor function tests, including walking speed, dual-task gait tests, and ambulation ability. Recovery from MCR may include cognitive, physical, and social activities, exercise, diet, nutritional supplements, symptomatic drug treatment, and lifestyle habits that restrict the disease progression. Psychotherapeutic counseling, anti-depressants, and vitamins may support motor and cognitive improvement, primarily through the restorative pathways. However, an in-depth understanding of the association of immobility, dementia, and cognitive stress with MCR requires additional clinical and pre-clinical studies. They may have a significant contribution in reducing MCR syndrome and the risk for dementia. Overall, the current review informs the vital connection between gait performance and cognition in MCR and highlights the usefulness of future research in the discernment and treatment of dementiating illness.

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Motoric Cognitive Risk Syndrome in Polypharmacy

Cited by 16 publications

References 20 publications

Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model

Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model

Síndrome de risco cognitivo motor em pessoas idosas de um serviço de saúde do Distrito Federal: estudo transversal

Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery

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