Slow gait coupled with cognitive decline may predict dementia

the Clinical Advisor take:

An increased incidence of motoric cognitive risk (MCR) syndrome, a newly described pre-dementia syndrome defined by slow gait and cognitive complaints, was found in aging patients, results of a study published in Neurology indicate.

“We know that about half of cases of dementia go undiagnosed in primary-care settings,”  Joe Verghese, MBBS, of the Albert Einstein College of Medicine in Bronx, New York, told MedPage Today.

A decline in gait speed may help identify patients at risk for developing dementia, said Verghese, noting that his older patients who walked slowly were more likely to also have clinically significant cognitive decline.

To report incidence rates and risk factors for MCR, including gait speed, the investigators examined 3,128 patients aged 60 years and older who were MCR- and dementia-free at baseline who participated in four United States-based cohort studies.

Over a median follow-up time of 3.2 years, 823 patients met MCR criteria. The overall age- and sex-adjusted incidence of MCR was 65.2 per 1,000 person years (95% CI: 53.3-77.1), and ranged from 50.8 per 1,000 person-years to 79.6 per 1,000 person-years in the individual cohorts.

MCR incidence increased with age but there were no sex differences. In the pooled sample adjusted for age, sex, education, and cohort source, strokes (hazard ratio (HR), 1.42; 95% CI: 1.14-1.77); Parkinson disease (HR, 2.52; 95% CI: 1.68-3.76), depressive symptoms (HR, 1.65, 95% CI: 1.28-2.13), sedentariness (HR, 1.76; 95% CI: 1.44-2.17), and obesity (HR, 1.39; 95% CI: 1.17-1.65) predicted risk of incident MCR.

“Identification of modifiable risk factors for MCR will improve identification of high-risk individuals and help develop interventions to prevent cognitive decline in aging,” concluded the investigators.