Division of Cognitive & Motor Aging, Saul R Korey Department of Neurology, Albert Einstein College of Medicine, 1165 Morris Park Avenue, Rousso 301, Bronx, NY 10461, USA.
J Gerontol A Biol Sci Med Sci. 2013 Apr;68(4):412-8. doi: 10.1093/gerona/gls191. Epub 2012 Sep 17.
Despite growing evidence of links between gait and cognition in aging, cognitive risk assessments that incorporate motoric signs have not been examined. We sought to validate a new Motoric Cognitive Risk (MCR) syndrome to identify individuals at high risk of developing dementia.
We evaluated 997 community residing individuals aged 70 and older participating in the Einstein Aging Study over a median follow-up time of 36.9 months. MCR syndrome was defined as presence of cognitive complaints and slow gait (one standard deviation below age- and sex-specific gait speed means) in nondemented individuals. Cox models were used to evaluate the effect of MCR syndrome on the risk of developing dementia and subtypes.
Fifty-two participants met criteria for MCR syndrome at baseline with a prevalence of 7% (95% CI: 5-9%). Prevalence of MCR increased with age. Participants with MCR were at higher risk of developing dementia (hazard ratio [HR] adjusted for age, sex, and education: 3.27, 95% CI: 1.55-6.90) and vascular dementia (adjusted HR: 12.81, 95% CI: 4.98-32.97). The association of MCR with risk of dementia or vascular dementia remained significant even after accounting for other confounders and diagnostic overlap with "cognitive" mild cognitive impairment syndrome subtypes.
A motor-based MCR syndrome provides a clinical approach to identify individuals at high risk for dementia, especially vascular dementia, to target for further investigations and who may benefit from preventive interventions.
尽管越来越多的证据表明步态和认知在衰老过程中存在关联，但尚未对纳入运动迹象的认知风险评估进行研究。我们试图验证一种新的运动认知风险（MCR）综合征，以识别有发展为痴呆风险的个体。
我们评估了 997 名年龄在 70 岁及以上、居住在社区的爱因斯坦老龄化研究参与者，中位随访时间为 36.9 个月。在认知正常的个体中，MCR 综合征的定义为存在认知主诉和步态缓慢（低于年龄和性别特异性步态速度平均值一个标准差）。Cox 模型用于评估 MCR 综合征对发展为痴呆和亚型的风险的影响。
52 名参与者在基线时符合 MCR 综合征标准，患病率为 7%（95%CI：5-9%）。MCR 的患病率随年龄增长而增加。患有 MCR 的参与者发展为痴呆的风险较高（年龄、性别和教育调整后的风险比 [HR]：3.27，95%CI：1.55-6.90）和血管性痴呆（调整后的 HR：12.81，95%CI：4.98-32.97）。即使考虑到其他混杂因素以及与“认知”轻度认知障碍综合征亚型的诊断重叠，MCR 与痴呆或血管性痴呆风险的关联仍然显著。
基于运动的 MCR 综合征为识别痴呆风险较高的个体（尤其是血管性痴呆）提供了一种临床方法，以针对这些个体进行进一步调查，并可能受益于预防干预措施。
