Geriatric Clinic Unit, Medicine and Geriatric-Rehabilitation Department, and Department of Medicine and Surgery, University of Parma, University Hospital of Parma, Parma, Italy.
Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University Hospital of Parma, Parma, Italy.
J Cachexia Sarcopenia Muscle. 2019 Oct;10(5):953-955. doi: 10.1002/jcsm.12476. Epub 2019 Aug 13.
A new syndrome called the 'motoric-cognitive risk' (MCR) syndrome has recently been proposed in older persons. According to this definition, the parallel impairment in muscle and brain function is more predictive for identifying subjects at risk of dementia than impairment a in single system alone. Epidemiological studies suggest that among older persons, enrolled in worldwide population-based studies, 10% are affected by this syndrome, which confers a higher risk of future disability. In detail, the prevalence of MCR in Europe is around 8.0%, 7.0% in the United States, and 6.3% in Japan. The incidence of the MCR syndrome is estimated to be 65.2 per 1000 person years in adults aged 60 years or older. Many studies reported negative outcomes of the syndrome in older persons, emphasizing its clinical impact. In particular, in almost all longitudinal studies, MCR produces a three-time increased risk of future dementia. In Europe, data from the InCHIANTI study report an increased risk of 2.74 [1.54-4.86], which is 2.49 [1.52-4.10] in the United States and 3.27 [1.55-6.90] in Japan. The studies in different continents are also consistent in showing an increased risk of all-cause mortality, which is 1.50-1.87 in the Europeans and 1.69 [1.08-2.02] for incident disability in Japan. For the identification of the MCR syndrome, different tests and procedures have been proposed, with a final 'core-battery' that includes gait speed, dual-task gait speed, the Montreal Cognitive Assessment and Trail Making Test A and B. The criteria used to select this core-battery were based on the best accuracy for identifying older persons at risk of negative outcomes such as dementia, falls, aging-related disabilities, and sensitivity to interventions. The selection of these tests will allow to start studies aimed to better capture older persons at higher risk of mobility and cognitive disability. By these tests, it will be possible to better evaluate the effect of treatment composing of tailored physical exercise, nutritional suggestions, and medical therapy to overturn negative effect of both cognitive and motoric frailty. This article provides an overview of the current knowledge of the MCR syndrome.
一种新的综合征，称为“运动认知风险（MCR）综合征”，最近在老年人中被提出。根据这一定义，肌肉和大脑功能的平行损伤比单一系统的损伤更能预测痴呆风险。流行病学研究表明，在全球人群研究中，10%的老年人受到这种综合征的影响，这会增加未来残疾的风险。具体而言，欧洲 MCR 的患病率约为 8.0%，美国为 7.0%，日本为 6.3%。估计年龄在 60 岁或以上的成年人中，MCR 综合征的发病率为每 1000 人年 65.2 例。许多研究报告了老年人 MCR 综合征的不良后果，强调了其临床影响。特别是，在几乎所有的纵向研究中，MCR 使未来痴呆的风险增加了三倍。在欧洲，INCHIANTI 研究的数据报告风险增加了 2.74[1.54-4.86]，在美国增加了 2.49[1.52-4.10]，在日本增加了 3.27[1.55-6.90]。来自不同大陆的研究也一致表明，全因死亡率的风险增加了 1.50-1.87，而在欧洲，发生残疾的风险增加了 1.69[1.08-2.02]。为了识别 MCR 综合征，已经提出了不同的测试和程序，最终的“核心电池”包括步态速度、双任务步态速度、蒙特利尔认知评估和连线测试 A 和 B。选择这个核心电池的标准是基于对识别有痴呆、跌倒、与衰老相关的残疾和对干预措施敏感等不良后果风险的老年人的最佳准确性。选择这些测试将有助于开展旨在更好地识别有更高移动性和认知障碍风险的老年人的研究。通过这些测试，可以更好地评估针对认知和运动脆弱性的量身定制的身体锻炼、营养建议和医学治疗的效果，以扭转其负面影响。本文概述了 MCR 综合征的最新知识。
