Motoric cognitive risk syndrome, incident cognitive impairment and morphological brain abnormalities: Systematic review and meta-analysis

Sekhon, Harmehr; Allali, Gilles; Launay, Cyrille P.; Barden, John M.; Szturm, Tony; Liu-Ambrose, Teresa; Chester, Victoria; Wong, Chek Hooi; Beauchet, Olivier

doi:10.1016/j.maturitas.2019.02.006

Cited by 48 publications

(65 citation statements)

References 38 publications

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“…However, NAD and, in particular, vascular dementia have been associated with MCR. Further, its association with incident vascular dementia was greater than AD incidence . The divergence between our results and those of previous studies may be explained by the fact that it was not possible to characterize the etiology of NAD in Toulouse EPIDOS participants and that this cohort only includes women.…”

Section: Discussioncontrasting

confidence: 99%

“…In all, MCR was associated with incident dementia in the EPIDOS French female cohort. The strength of this association was similar to previous studies’ findings, with a 2‐fold increased risk of incident dementia in MCR individuals . This result is consistent with the associations previously reported in North American cohorts and confirms that MCR is a pre‐dementia stage .…”

Section: Discussionsupporting

confidence: 92%

“…The strength of this association was similar to previous studies' findings, with a 2-fold increased risk of incident dementia in MCR individuals [1][2][3]. This result is consistent with the associations previously reported in North American cohorts and confirms that MCR is a pre-dementia stage [3]. MCR's conceptual bases are to be found in the interaction between mobility and cognitive functions at the onset of the pathophysiological process underlying dementia, regardless of its type (i.e.…”

Section: Discussionsupporting

confidence: 91%

“…Our study showed that MCR status predicts AD but not NAD. Its predictive ability for AD has been reported previously and is consistent with the fact that AD is associated with poor gait ability, even at its onset . However, NAD and, in particular, vascular dementia have been associated with MCR.…”

Section: Discussionsupporting

confidence: 89%

“…Recently, a meta-analysis confirmed the association between MCR and incident dementia (pooled hazard ratio 2.50 with P value ≤0.001), this association being stronger than if MCR's individual components were considered in isolation (i.e. slow gait speed and SCC alone) [3]. These results underscore the clinical significance of MCR for predicting dementia in the older population and that MCR is not only a research model based on the interaction between cognition and mobility [4].…”

Section: Introductionmentioning

confidence: 93%

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Motoric cognitive risk syndrome and incident dementia: results from a population‐based prospective and observational cohort study

Beauchet

Sekhon

Launay

et al. 2019

Euro J of Neurology

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Background and purpose Motoric cognitive risk syndrome (MCR), which is the juncture of subjective cognitive complaint and slow gait speed, is a pre‐dementia stage. The aims of the study are (i) to compare characteristics between individuals who have MCR defined using slow walking speed and/or increased five‐times‐sit‐to‐stand (FTSS) time as its motor component(s); and (ii) to characterize the association of MCR and its various motor components with incident dementia including Alzheimer disease and non‐Alzheimer dementia in the participants of the Epidémiologie de l’Ostéoporose (EPIDOS) study. Methods This prospective and observational cohort study selected 651 participants recruited from the EPIDOS study in Toulouse (France). MCR was defined as the association of subjective cognitive complaint and slow gait speed and/or increased FTSS time in participants without either dementia and mobility disabilities at baseline. Individuals with dementia were prospectively diagnosed during the physical and neuropsychological assessments included in the 7‐year follow‐up. Results The prevalence of MCR was around 7% when using an exclusive motor criterion, either slow gait speed or increased FTSS time, and was 20.9% when MCR subgroups were pooled. MCR was positively associated with incident dementia regardless of its type, and with Alzheimer disease in the slow gait speed MCR subgroup [odds ratio (OR) > 2.18 with P ≤ 0.037] but not with non‐Alzheimer dementia. No significant association between incident dementia and MCR defined using increased FTSS time was shown. Conclusions Our findings confirm that MCR is associated with incident dementia and that slow gait speed is the appropriate motor criterion for detecting dementia risk.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 93%

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Motoric cognitive risk syndrome and incident dementia: results from a population‐based prospective and observational cohort study

Beauchet

Sekhon

Launay

et al. 2019

Euro J of Neurology

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Motoric Cognitive Risk and Incident Dementia in Older Adults

Chung,

Byun

2023

JAMA Netw Open

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ImportanceMotoric cognitive risk (MCR) is a novel predementia syndrome; however, whether it can estimate dementia in a nationwide population or has additive estimation validity over cognitive or motoric components alone remains unknown.ObjectiveTo examine whether modified MCR, which incorporates the timed-up-and-go and one-leg-standing tests, improves estimation validity for incident dementia over using cognitive or motoric components alone.Design, Setting, and ParticipantsThis nationwide cohort study evaluated data from individuals aged 66 years who participated in the National Screening Program for Transitional Ages in Korea from January 1, 2009, to December 31, 2013, and examined the association between MCR and incident dementia using Cox proportional hazards regression analysis. Data were collected from the index date (the date on which the participant had the screening) until dementia onset, death, or the end of the follow-up period, whichever came first. The 2 subtypes were defined as subjective cognitive declines with timed-up-and-go impairment or one-leg-standing impairment. The data set was generated with permission from the Korean National Health Insurance Service, and data analysis was conducted from August 2, 2021, to January 31, 2022. Individuals diagnosed with dementia or psychotic disorders or those who had a documented history of dementia medication use before the index date were excluded.Main Outcomes and MeasuresThe main outcome was incidence of dementia, defined as an individual receiving their first dementia medication with the relevant International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes after the index date.ResultsAmong the 1 137 530 participants (53.7% women), 15 380 (1.4%) met the MCR criteria for the timed-up-and-go subtype, and 32 910 (2.9%) met the criteria for the one-leg-standing subtype. The mean (SD) follow-up period was 7.02 (1.38) years. Participants with MCR demonstrated an approximately 2-fold higher risk of incident dementia than those without MCR (timed-up-and-go subtype, adjusted hazard ratio, 2.03; 95% CI, 1.94-2.13; one-leg-standing subtype, adjusted hazard ratio, 2.05; 95% CI, 1.98-2.12).Conclusions and RelevanceIn this cohort study of participants aged 66 years of the National Screening Program for Transitional Ages, modified motoric cognitive risk had higher adjusted hazard ratios of incident dementia than individual cognitive or motoric components. Motoric cognitive risk may be a practical screening tool for estimating dementia among individuals in their mid-60s ; however, further investigation of the clinical and neurobiological aspects is necessary.

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The association of motoric cognitive risk with incident dementia and neuroimaging characteristics: The Atherosclerosis Risk in Communities Study

Gómez

Gottesman

Gabriel

et al. 2021

Alzheimer's & Dementia

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Introduction Motoric cognitive risk (MCR), a clinical syndrome characterized by slow gait speed and subjective cognitive complaints, has been associated with dementia risk. The neuropathological features underlying MCR remain poorly understood. Methods The Atherosclerosis Risk in Communities (ARIC) community‐based cohort study classified participants using standardized criteria as MCR+/– and mild cognitive impairment (MCI)+/– at study baseline (2011–2013). We examined the 5‐year dementia risk and baseline brain structural/molecular abnormalities associated with MCR+ and MCI+ status. Results Of 5023 nondemented participants included, 204 were MCR+ and 1030 were MCI+. Both MCR+ and MCI+ participants demonstrated increased dementia risk. The pattern of structural brain abnormalities associated with MCR+ differed from that of MCI+. Whereas MCI+ was associated with comparatively smaller volumes in brain regions vulnerable to Alzheimer's disease pathology, MCR+ status was associated with smaller volumes in frontoparietal regions and greater white matter abnormalities. Discussion MCR may represent a predementia syndrome characterized by prominent white matter abnormalities and frontoparietal atrophy.

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Motoric cognitive risk syndrome, incident cognitive impairment and morphological brain abnormalities: Systematic review and meta-analysis

Cited by 48 publications

References 38 publications

Motoric cognitive risk syndrome and incident dementia: results from a population‐based prospective and observational cohort study

Motoric cognitive risk syndrome and incident dementia: results from a population‐based prospective and observational cohort study

Motoric Cognitive Risk and Incident Dementia in Older Adults

The association of motoric cognitive risk with incident dementia and neuroimaging characteristics: The Atherosclerosis Risk in Communities Study

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