Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ageing Res Rev. 2024 Nov;101:102470. doi: 10.1016/j.arr.2024.102470. Epub 2024 Sep 6.
Motoric cognitive risk syndrome (MCR) is defined as the presence of slow gait-speed and subjective cognitive decline in older individuals without mobility disability or dementia. While some studies suggest that MCR is a pre-dementia syndrome and may help predict the risk of cognitive impairment and dementia, not all studies concur. The objective of this study is to comprehensively summarize and synthesize evidence to assess the association between MCR and cognitive impairment and dementia.
Following a pre-specified protocol, two authors systematically searched PubMed, Embase, and The Cochrane Library from inception to 19 August 2024 for observational or randomized studies pertaining to the association between MCR and cognitive impairment and dementia. We favoured maximally adjusted hazards and odds ratios to determine the longitudinal and cross-sectional risk of cognitive impairment and dementia. We investigated for potential sources of heterogeneity and also conducted sensitivity and subgroup analyses by continent and the type of cognitive outcome. The quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS) and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework.
We included 20 studies comprising a combined cohort of 1206,782 participants, of which 17 studies were included in the quantitative analysis. The pooled analysis outlined that individuals with MCR exhibited 2.20-fold higher risk of cognitive impairment and dementia, compared to controls (RR=2.20; 95 %CI=1.91-2.53). These findings remained robust across all subgroup analyses, sensitivity analyses and assessments of publication bias.
MCR may be considered a predictive factor for long-term cognitive impairment and dementia. This should be taken into consideration when clinically evaluating the risk of cognitive impairment and dementia but further research is required to lend greater clarity to this association.
运动认知风险综合征（MCR）定义为老年人在没有行动障碍或痴呆的情况下表现出缓慢的步态速度和主观认知下降。虽然一些研究表明 MCR 是一种前驱痴呆综合征，可能有助于预测认知障碍和痴呆的风险，但并非所有研究都同意这一观点。本研究的目的是全面总结和综合评估 MCR 与认知障碍和痴呆之间的关联证据。
根据预先制定的方案，两名作者系统地检索了 PubMed、Embase 和 The Cochrane Library，从成立到 2024 年 8 月 19 日，以检索关于 MCR 与认知障碍和痴呆之间关联的观察性或随机研究。我们倾向于使用最大调整后的风险比和优势比来确定认知障碍和痴呆的纵向和横断面风险。我们调查了潜在的异质性来源，并根据大陆和认知结果类型进行了敏感性和亚组分析。使用纽卡斯尔-渥太华量表（NOS）和推荐评估、制定与评估（GRADE）框架评估证据质量。
我们纳入了 20 项研究，共包含 1206782 名参与者的合并队列，其中 17 项研究纳入了定量分析。汇总分析表明，与对照组相比，患有 MCR 的个体认知障碍和痴呆的风险高 2.20 倍（RR=2.20；95%CI=1.91-2.53）。这些发现在所有亚组分析、敏感性分析和发表偏倚评估中均保持稳健。
MCR 可能被视为长期认知障碍和痴呆的预测因素。在临床评估认知障碍和痴呆的风险时应考虑到这一点，但需要进一步研究以更清楚地阐明这种关联。
