Abstract
Objectives
Slow gait has been shown to be a good predictor of declining cognitive function in
healthy older adults. Motoric cognitive risk (MCR) syndrome is a new construct incorporating
slow gait and subjective cognitive complaints in individuals without dementia who
have preserved activities of daily living. This analysis investigated the prevalence
of MCR and factors associated with MCR in a nationally representative population.
In addition, cross-sectional associations between MCR and cognitive domains, an relationship
yet to be fully elucidated in literature, was investigated.
Measurements
Participants completed a comprehensive neuropsychological assessment and gait analysis
at a health assessment center. Logistic regression was employed to examine associated
health factors. Composite scores reflecting global cognition, memory, sustained attention,
executive function, and processing speed were constructed using neuropsychological
test scores. Associations between MCR and these composites were quantified using multivariate
generalized linear modelling. All analyses were weighted to be nationally representative.
Setting
Community-dwelling adults in The Irish Longitudinal Study on Aging (TILDA) completed
an interview and a center-based health assessment.
Participants
Participants aged 60 years and over (n = 2151, age; mean: 67.84 years, range: 60-93)
were included. Participants with a Mini-Mental State Examination score of below 24,
a diagnosis of serious memory impairment, Parkinson disease, dementia, or Alzheimer
disease were excluded.
Results
MCR prevalence was estimated at 2.56% (95% confidence interval 1.97, 3.31). Significant
risk factors for MCR were antidepressant use [odds ratio (OR) 4.46, P < .001], self-reported poor vision (OR 4.92, P < .05), and obesity (OR 2.29, P < .01). Individuals with MCR performed worse on tests that assess memory (B: −0.58,
P < .001), global cognition (B: −0.42, P < .001), and sustained attention (B: −0.34, P < .05) with robust adjustment made for confounding demographic and health variables.
Conclusions
MCR is characterized by strong negative associations with global cognition, attention,
and memory. This may be indicative of the underlying pathology of MCR. The effect
of antidepressant use on MCR is novel and may represent an important consideration
in future studies.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the American Medical Directors AssociationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Gait and cognition: A complementary approach to understanding brain function and the risk of falling.J Am Geriatr Soc. 2012; 60: 2127-2136
- Relative association of processing speed, short-term memory and sustained attention with task on gait speed: A study of community-dwelling people 50 years and older.J Gerontol A Biol. 2014; 69: 1407-1414
- Motoric cognitive risk syndrome and the risk of dementia.J Gerontol A Biol Sci Med Sci. 2013; 68: 412-418
- Motoric cognitive risk syndrome: Prevalence and risk factors in Japanese seniors.J Am Med Dir Assoc. 2015; 16 (e1121-1103. e1125): 1103
- Motoric cognitive risk syndrome: Multicenter incidence study.Neurology. 2014; 83: 2278-2284
- Motoric cognitive risk syndrome: Multicountry prevalence and dementia risk.Neurology. 2014; 83: 718-726
- Motoric cognitive risk syndrome and falls risk: A multicenter study.J Alzheimers Dis. 2016; 53: 1043-1052
- Cerebral small vessel disease and motoric cognitive risk syndrome: Results from the Kerala-Einstein Study.J Alzheimers Dis. 2016; 50: 699-707
- Association of motoric cognitive risk syndrome with brain volumes: Results from the GAIT Study.J Gerontol A Biol Sci Med Sci. 2016; 71: 1081-1088
- Motoric cognitive risk syndrome subtypes and cognitive profiles.J Gerontol A Biol Sci Med Sci. 2016; 71: 378-384
- Neuroepidemiologic and neurobehavioral characteristics of motoric cognitive risk syndrome in an old-old population: The Kurihara Project.Dement Geriatr Cogn Dis Extra. 2016; 6: 176-182
- The spectrum of pre-dementia stages: Cognitive profile of motoric cognitive risk syndrome and relationship with mild cognitive impairment.Eur J Neurol. 2017; 24: 1047-1054
- Design and methodology of the Irish Longitudinal Study on Ageing.J Am Geriatr Soc. 2013; 61: S265-S268
- Motoric cognitive risk syndrome and risk of mortality in older adults.Alzheimer Dementia. 2016; 12: 556-564
- Conventional and robust quantitative gait norms in community-dwelling older adults: Gait norms.J Am Geriatr Soc. 2010; 58: 1512-1518
- Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function.JAMA. 1963; 185: 914-919
- “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975; 12: 189-198
- The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment.J Am Geriatr Soc. 2005; 53: 695-699
- CAMDEX-R Boxed Set: The Revised Cambridge Examination for Mental Disorders of the Elderly.Cambridge University Press, Cambridge1999
- Colour Trails Test: Professional Manual.Psychological Assessment Resources, Odessa, FL1996
- Sustained attention and frailty in the older adult population.J Gerontol B Psychol Sci Soc Sci. 2014; 69: 147-156
- Depression and physical health in later life: Results from the Longitudinal Aging Study Amsterdam (LASA).J Affect Disord. 1997; 46: 219-231
- Cognitive performance in orthostatic hypotension: Findings from a nationally representative sample.J Am Geriatr Soc. 2014; 62: 117-122
- Health and aging: Development of the Irish Longitudinal Study on Ageing health assessment.J Am Geriatr Soc. 2013; 61: S269-S278
- Assessing the temporal relationship between cognition and gait: Slow gait predicts cognitive decline in the Mayo Clinic Study of Aging.J Gerontol A Biol Sci Med Sci. 2013; 68: 929-937
- Cognitive function, gait, and gait variability in older people: A population-based study.J Gerontol A Biol Sci Med Sci. 2013; 68: 726-732
- Aging, memory, and mild cognitive impairment.Int Psychogeriatr. 1997; 9: 65-69
- Global and regional associations of smaller cerebral gray and white matter volumes with gait in older people.PLoS One. 2014; 9: e84909
- Antidepressants are independently associated with gait deficits in single and dual task conditions.Am J Geriatr Psychiatry. 2015; 23: 189-199
- A review of modern antidepressants' effects on neurocognitive function.Curr Psychiatry Rev. 2009; 5: 164-174
- Mild chronic hyponatremia is associated with falls, unsteadiness, and attention deficits.Am J Med. 2006; 119: 71.e1-71.e8
- Obesity-specific neural cost of maintaining gait performance under complex conditions in community-dwelling older adults.Clin Biomech (Bristol, Avon). 2016; 35: 42-48
- Longitudinal examination of obesity and cognitive function: Results from the Baltimore longitudinal study of aging.Neuroepidemiology. 2010; 34: 222-229
- Time to refocus assessment of vision in older adults? Contrast sensitivity but not visual acuity is associated with gait in older adults.J Gerontol A Biol Sci Med Sci. 2017; : glx021
Article info
Publication history
Published online: September 09, 2017
Footnotes
Funding for the TILDA project was supported by the Irish Government, the Atlantic Philanthropies, and Irish Life plc. These funders had no involvement in the study design, collection, analysis and interpretation of data, writing of the paper, or submission for publication. F.J.M. was supported by a bursary from the Association of Physicians of Great Britain and Ireland.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
