Motoric Cognitive Risk Syndrome Subtypes and Cognitive Profiles
Motoric Cognitive Risk Syndrome Subtypes and Cognitive Profiles
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DOI：
10.1093/gerona/glv092
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发表时间：
2016-03-01
影响因子：
5.1
通讯作者：
Verghese, Joe
中科院分区：
文献类型：
--
作者：
Allali, Gilles;Ayers, Emmeline I.;Verghese, Joe
背景运动性认知风险（MCR）综合征的特征是步态缓慢和认知障碍，是一种简单易行的临床方法，可用于识别老年人向痴呆症转变的高风险。本研究旨在根据个体定量步态变量定义MCR亚型，并比较其神经心理学特征和危险因素以及偶发性认知障碍的风险。在314名65岁及以上的社区居住、非痴呆、老年人（56%为女性）中，根据认知主诉和步态速度慢（MCRV）的存在诊断出MCR。通过用短步幅长度替代慢步态（MCRSl）、慢摆动时间（MCRSw）、高步幅长度变异性（MCRSlv）和高摆动时间变异性（MCRSwv）来定义MCR的四种新亚型。MCR亚型之间并不相互排斥。共有25例受试者（8%）符合MCRv标准，20例MCRsl（6.4%），15例MCRsw（4.8%），16例MCRsl v（5.1%），12例MCRsw（3.8%），266例受试者（84.7%）不符合任何MCR亚型标准。在基线时，MCRv与注意力和语言以及整体认知状态的缺陷相关。MCRswv与包括记忆在内的所有认知领域的缺陷相关。肥胖和久坐是MCRv、MCRsl和MCRsw的危险因素。MCRv状态可预测整体认知中的偶发性认知损害（优势比：3.59，p = .016），而MCRswv状态可预测记忆中的偶发性认知损害（优势比：4.24，p = .048）。基于个体步态参数的MCR亚型在认知特征和风险因素方面存在共性和差异。未来的研究应该调查MCR亚型是否预测不同的痴呆亚型。
Background. The motoric cognitive risk (MCR) syndrome, characterized by slow gait and cognitive complaints, is a simple and easily accessible clinical approach to identify older adults at high risk for transitioning to dementia. This study aims to define subtypes of MCR based on individual quantitative gait variables and to compare their neuropsychological profiles and risk factors as well risk for incident cognitive impairment.Methods. MCR was diagnosed in 314 community-residing, nondemented, older adults aged 65 and older (56% women) based on the presence of cognitive complaints and slow gait velocity (MCRv). Four new subtypes of MCR were defined by substituting slow gait with short stride length (MCRsl), slow swing time (MCRsw), high stride length variability (MCRslv), and high swing time variability (MCRswv). MCR subtypes were not mutually exclusive.Results. A total of 25 participants (8%) met criteria for MCRv, 20 for MCRsl (6.4%), 15 for MCRsw (4.8%), 16 for MCRslv (5.1%), 12 for MCRswv (3.8%), and 266 participants (84.7%) did not meet criteria for any MCR subtype. At baseline, MCRv was associated with deficits in attention and language as well as in overall cognitive status. MCRswv was associated with deficits in all cognitive domains including memory. Obesity and sedentariness were risk factors of MCRv, MCRsl, and MCRsw. MCRv status predicted incident cognitive impairment in global cognition (odds ratio: 3.59, p = .016), whereas MCRswv status predicted incident cognitive impairment in memory (odds ratio: 4.24, p = .048).Conclusions. MCR subtypes based on individual gait parameters show commonalities and differences in cognitive profiles and risk factors. Future studies should investigate whether the MCR subtypes predict different subtypes of dementia.