van der Leeuw Guusje, Ayers Emmeline, Blankenstein Annette H, van der Horst Henriëtte E, Verghese Joe
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands.
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
Arch Gerontol Geriatr. 2020 Mar-Apr;87:103991. doi: 10.1016/j.archger.2019.103991. Epub 2019 Nov 30.
The Motoric Cognitive Risk Syndrome (MCR) is a pre-dementia syndrome characterized by subjective cognitive complaints and slow gait in the absence of dementia and mobility disability. Worse cognitive and motoric function is associated with chronic pain in older adults. Our aim was to study the association between pain and prevalent and incident MCR in adults aged 65 years and older.
We analyzed the cross-sectional association between severity of pain and prevalent MCR in 3244 older adults participating in the Health and Retirement Study (2008 wave) using logistic regression analysis adjusting for demographic, peripheral, central or biological risk factors. Additionally, we analyzed the longitudinal association between severity of pain and incident MCR in 362 participants in the Central Control of Mobility in Aging Study, using Cox regression analysis.
The 155 Health and Retirement Study participants with severe pain had an increased risk of prevalent MCR (n = 249), compared to 2245 individuals without pain (adjusted for demographics OR: 2.78, 95 % CI:1.74-4.45). Over a mean follow-up of 3.01 years (SD 1.38), 29 individuals in the Central Control of Mobility in Aging Study developed incident MCR. Older adults with severe pain had over a five times increased risk of developing incident MCR, compared to those without pain even after adjusting for demographic variables (HR: 5.44, 95 % CI: 1.81-16.40).
Older adults with severe pain have a higher prevalence and incidence of MCR. These findings should be further explored to establish if pain is a potentially modifiable risk factor to prevent cognitive decline.
运动认知风险综合征（MCR）是一种痴呆前综合征，其特征为在无痴呆和行动障碍的情况下出现主观认知主诉和步态缓慢。老年人认知和运动功能较差与慢性疼痛有关。我们的目的是研究65岁及以上成年人中疼痛与MCR患病率及发病率之间的关联。
我们对参与健康与退休研究（2008年波次）的3244名老年人进行了逻辑回归分析，以调整人口统计学、外周、中枢或生物学风险因素，分析疼痛严重程度与MCR患病率之间的横断面关联。此外，我们对衰老过程中运动的中枢控制研究中的362名参与者进行了Cox回归分析，以分析疼痛严重程度与MCR发病率之间的纵向关联。
与2245名无疼痛个体相比，健康与退休研究中155名有严重疼痛的参与者患MCR（n = 249）的风险增加（经人口统计学调整后的比值比：2.78，95%置信区间：1.74 - 4.45）。在衰老过程中运动的中枢控制研究中，平均随访3.01年（标准差1.38），有29名个体发生了MCR。即使在调整人口统计学变量后，有严重疼痛的老年人发生MCR的风险也比无疼痛者高出五倍多（风险比：5.44，95%置信区间：1.81 - 16.40）。
有严重疼痛的老年人MCR的患病率和发病率更高。应进一步探讨这些发现，以确定疼痛是否是预防认知衰退的潜在可改变风险因素。
