Motoric Cognitive Risk Syndrome and Falls Risk: A Multi-Center Study

Abstract

Background The Motoric Cognitive Risk Syndrome (MCR) is characterized by slow gait speed and cognitive complaints. Objectives The objective of this study was to determine if the presence of MCR increases the risk of falls in older people. Methods Individual participant data (n = 6,204) from five longitudinal studies from three countries were used for this analysis. MCR diagnosis was defined as both the presence of objectively measured slow gait speed and subjective cognitive complaints in those without dementia or mobility disability. Falls were prospectively ascertained using phone calls or questionnaires. Log binomial regression was performed to determine if MCR increased the risk of falls separately in each cohort. Random effects meta-analysis was used to pool results from all cohorts. Results The mean age of participants was 74.9 (SD 6.8) years and 44% (n = 2728) were male. Overall 33.9% (n = 2104) reported a fall over follow-up. Pooled relative risk of MCR with any falls was RR 1.44 95% CI 1.16, 1.79. The components of MCR, slow gait (RR 1.30 95% CI 1.14, 1.47) and cognitive complaint (RR 1.25, 95% CI 1.07, 1.46) were also associated with an increased risk of any falls. In sub-analyses MCR was associated with any fall independent of previous falls (RR 1.29 95% CI 1.09, 1.53) and with multiple falls (RR 1.77, 95% CI 1.25, 2.51). Conclusion MCR is associated with an increased risk of falls. The increase in risk was higher than for its individual components. The simplicity of the MCR makes it an attractive falls risk screening tool for the clinic.

Motoric Cognitive Risk Syndrome: Association with Incident Dementia and Disability

“…This finding is not unexpected as slow gait may capture other non-cognitive pathways leading to disability [28]. Interestingly, other studies have also expanded the clinical utility of MCR into predicting non-dementia outcomes such as mortality [29] and falls [30].…”

Personality and Motoric Cognitive Risk Syndrome

“…Given that MCR is a significant pre‐dementia syndrome, it could be an intermediate manifestation of the risk of dementia associated with these traits. Furthermore, MCR is related to higher risk of falls, and as such, it could mediate the association between higher neuroticism and lower conscientiousness and the risk of incident falls …”

“…T he motoric cognitive risk (MCR), a pre-dementia syndrome defined by cognitive complaints and slower walking speed, 1-3 is receiving broad attention because MCR is associated with increased risk of developing cognitive impairment and dementia, 2,4,5 as well as disability, falls, and mortality. [5][6][7][8] For example, MCR is associated with a 2-to 3-fold higher risk of incident dementia. 2,4 Several factors increase risk of MCR including lower education, older age, cardiovascular risk factors such as obesity and stroke, Parkinson's disease, physical inactivity, and depressive symptoms.…”

Reliability and construct validity of a novel motor–cognitive dual‐task test: A Stepping Trail Making Test

“…Emerging evidence suggests that the decline in such interactions based on aging and neurodegeneration is associated with an increased risk of dementia and falls . For example, Motoric Cognitive Risk Syndrome, a clinical feature defined as slow walking speed and subjective decline in cognition, is 3.3 times more likely to progress to dementia and 1.4 times more likely to increase the incidence of falls …”

“…2,3 For example, Motoric Cognitive Risk Syndrome, a clinical feature defined as slow walking speed and subjective decline in cognition, is 3.3 times more likely to progress to dementia and 1.4 times more likely to increase the incidence of falls. 4,5 The Canadian Consortium on Neurodegeneration in Aging has indicated the importance of applying an integrated approach to measuring motor and cognitive functions, and proposed a complementary battery of assessments that captures motor-cognitive interactions in older adults. 1 This assessment battery includes dual-task gait as the core test.…”