Motoric Cognitive Risk Syndrome and the Risk of Dementia
Motoric Cognitive Risk Syndrome and the Risk of Dementia
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DOI：
10.1093/gerona/gls191
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发表时间：
2013-04-01
影响因子：
5.1
通讯作者：
Holtzer, Roee
中科院分区：
文献类型：
--
作者：
Verghese, Joe;Wang, Cuiling;Holtzer, Roee
尽管越来越多的证据表明步态和认知之间的联系，在老化，认知风险评估，包括运动的迹象还没有被检查。我们试图验证一种新的运动认知风险（MCR）综合征，以确定个人在发展成痴呆症的高风险。我们评估了997个社区居住的70岁及以上的人参加了爱因斯坦老龄化研究超过36.9个月的中位数随访时间。MCR综合征被定义为非痴呆个体存在认知障碍和步态缓慢（低于年龄和性别特异性步态速度平均值的一个标准差）。采用考克斯模型评估MCR综合征对痴呆及其亚型发生风险的影响。52名参与者在基线时符合MCR综合征标准，患病率为7%（95%CI：59%）。MCR患病率随年龄增长而增加。MCR参与者发生痴呆的风险较高（根据年龄、性别和教育调整的风险比[HR]：3.27，95% CI：1.556.90）和血管性痴呆（调整的HR：12.81，95% CI：4.9832.97）。MCR与痴呆或血管性痴呆风险的相关性仍然显著，即使考虑了其他混杂因素和与认知轻度认知障碍综合征亚型的诊断重叠。基于运动的MCR综合征提供了一种临床方法来识别痴呆（尤其是血管性痴呆）高危个体，以作为进一步研究的目标，并可能从预防性干预中获益。
Despite growing evidence of links between gait and cognition in aging, cognitive risk assessments that incorporate motoric signs have not been examined. We sought to validate a new Motoric Cognitive Risk (MCR) syndrome to identify individuals at high risk of developing dementia.We evaluated 997 community residing individuals aged 70 and older participating in the Einstein Aging Study over a median follow-up time of 36.9 months. MCR syndrome was defined as presence of cognitive complaints and slow gait (one standard deviation below age- and sex-specific gait speed means) in nondemented individuals. Cox models were used to evaluate the effect of MCR syndrome on the risk of developing dementia and subtypes.Fifty-two participants met criteria for MCR syndrome at baseline with a prevalence of 7% (95% CI: 59%). Prevalence of MCR increased with age. Participants with MCR were at higher risk of developing dementia (hazard ratio [HR] adjusted for age, sex, and education: 3.27, 95% CI: 1.556.90) and vascular dementia (adjusted HR: 12.81, 95% CI: 4.9832.97). The association of MCR with risk of dementia or vascular dementia remained significant even after accounting for other confounders and diagnostic overlap with cognitive mild cognitive impairment syndrome subtypes.A motor-based MCR syndrome provides a clinical approach to identify individuals at high risk for dementia, especially vascular dementia, to target for further investigations and who may benefit from preventive interventions.