Callisaya Michele L, Ayers Emmeline, Barzilai Nir, Ferrucci Luigi, Guralnik Jack M, Lipton Richard B, Otahal Petr, Srikanth Velandai K, Verghese Joe
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Department of Medicine, Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia.
J Alzheimers Dis. 2016 Jun 18;53(3):1043-52. doi: 10.3233/JAD-160230.
The Motoric Cognitive Risk Syndrome (MCR) is characterized by slow gait speed and cognitive complaints.
The objective of this study was to determine if the presence of MCR increases the risk of falls in older people.
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.
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).
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.
运动认知风险综合征(MCR)的特征为步态速度缓慢和认知方面的主诉。
本研究的目的是确定MCR的存在是否会增加老年人跌倒的风险。
来自三个国家的五项纵向研究的个体参与者数据(n = 6204)用于该分析。MCR诊断定义为在无痴呆或行动障碍的人群中,同时存在客观测量的步态速度缓慢和主观认知方面的主诉。通过电话或问卷前瞻性地确定跌倒情况。进行对数二项回归以确定MCR在每个队列中是否分别增加跌倒风险。采用随机效应荟萃分析汇总所有队列的结果。
参与者的平均年龄为74.9(标准差6.8)岁,44%(n = 2728)为男性。总体而言,33.9%(n = 2104)报告在随访期间有跌倒。MCR与任何跌倒相关的合并相对风险为RR 1.44,95%置信区间为1.16, 1.79。MCR的组成部分,步态缓慢(RR 1.30,95%置信区间为1.14, 1.47)和认知方面的主诉(RR 1.25,95%置信区间为1.07, 1.46)也与任何跌倒风险增加相关。在亚组分析中,MCR与任何跌倒相关,独立于既往跌倒情况(RR 1.29,95%置信区间为1.09, 1.53),并与多次跌倒相关(RR 1.77,95%置信区间为1.25, 2.51)。
MCR与跌倒风险增加相关。风险增加高于其各个组成部分。MCR的简单性使其成为临床上有吸引力的跌倒风险筛查工具。