Association of peak expiratory flow with motoric cognitive risk syndrome among older adults
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SUBMITTER: Xu H
PROVIDER: S-EPMC11335682 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:IntroductionMotoric cognitive risk syndrome (MCR) is a predementia syndrome that is characterized by cognitive complaints and slow gait. Cardiometabolic multimorbidity (CMM) is associated with an increased risk of dementia. However, the relationship between CMM and MCR is still unclear.MethodsWe included 4744 participants (aged 65+ years) without MCR at baseline from the National Health and Aging Trends Study (NHATS), who were followed-up from 2011 to 2018. CMM was defined as the presence of two or more cardiometabolic diseases (including diabetes mellitus, heart disease, and stroke).ResultsCMM was significantly associated with an increased risk of MCR (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.13-1.75) in fully adjusted models. Consistent results were observed from stratified analyses of different subgroups. Increasing numbers of cardiometabolic diseases were dose-dependently associated with increased MCR risk (HR 1.33, 95% CI 1.20-1.48).DiscussionCMM is associated with an increased risk of MCR in older adults.HighlightsMotoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by slow gait speed and cognitive complaints.Cardiometabolic multimorbidity was associated with an increased MCR risk.An increased number of cardiometabolic diseases were dose-dependently associated with increased MCR risk.
| S-EPMC10626031 | biostudies-literature
Project description:The purpose of this study was to characterize Cognitive Motor Dual Task (CMDT) costs for a community-based sample of older adults with Motoric Cognitive Risk Syndrome (MCR), as well as investigate associations between CMDT costs and cognitive performance. Twenty-five community-dwelling older adults (ages 60-89 years) with MCR performed single and dual task complex walking scenarios, as well as a computerized cognitive testing battery. Participants with lower CMDT costs had higher scores on composite measures of Working Memory, Processing Speed, and Shifting, as well as an overall cognitive composite measure. In addition, participants with faster single task gait velocity had higher scores on composite measures of Working Memory, Processing Speed, and overall cognition. Taken together, these results suggest that CMDT paradigms can help to elucidate the interplay between cognitive and motor abilities for older adults with MCR.
| S-EPMC9397542 | biostudies-literature
Project description:BackgroundModifiable lifestyle factors such as diet are associated with cognitive decline and dementia. Greater understanding of the nutritional intake of older adults who are at increased risk for cognitive decline may allow for the development of more effective dietary interventions to prevent or delay the onset of dementia.ObjectivesThe purpose of this study was to characterize the nutritional status, diet quality and individual nutritional components of older adults with motoric cognitive risk syndrome (MCR). MCR is a pre-dementia syndrome classified by slow gait speed and subjective memory impairments.DesignCross-sectional analysis.SettingA community-based senior center located in an urban setting.ParticipantsTwenty-five community-dwelling older adults with MCR aged 60-89 yrs.MeasurementsNutritional risk status was determined using the Nestle Mini Nutritional Assessment (MNA). A food frequency questionnaire was used to quantify: overall dietary quality using the Healthy Eating Index (HEI); adherence to the Mediterranean-DASH for Neurodegenerative Delay (MIND) dietary pattern; and intake of individual nutritional components shown to be protective or harmful for cognitive function in older adults. Participants completed a computerized cognitive testing battery to assess cognitive abilities.ResultsMore than one third (36%) of participants were at increased risk for malnutrition. Participants at lower risk for malnutrition had better working memory (r = 0.40, p = 0.04), executive functioning (r = 0.44, p = 0.03), and overall cognition (r = 0.44, p = 0.03). While participants generally consumed a reasonable quality diet (HEI = 65.15), 48% of participants had poor adherence to a neuroprotective MIND dietary pattern. Higher intake of B-complex vitamins was associated with better task switching (r = 0.40, p ≤ 0.05) and faster processing speeds (r = 0.39, p ≤ 0.05). Higher vitamin C intake was associated with better executive functioning (r = 0.40, p ≤ 0.05).ConclusionsOur findings suggest that a significant proportion of older adults with MCR may be at increased risk for malnutrition. While the diet quality of older adults with MCR appeared to need improvement, future studies should investigate the effects of more specific nutritional interventions, including the MIND diet, on cognition in at-risk older adults.
| S-EPMC9410506 | biostudies-literature
Project description:BackgroundMotoric cognitive risk syndrome (MCR) is a predementia condition that combines slow gait speed and subjective cognitive concerns (SCC). The SCC criterion is presently unstandardized, possibly limiting risk detection. We sought to (a) characterize SCC practices through MCR literature review; (b) investigate the ability of SCC in slow gait individuals in predicting the likelihood of cognitive impairment in a demographically diverse sample of community-dwelling, nondemented older adults.MethodsFirst, we comprehensively reviewed the MCR literature, extracting information regarding SCC measures, items, sources, and cognitive domain. Next, Einstein Aging Study (EAS) participants (N = 278, Mage = 77.22 ± 4.74, %female = 67, Meducation = 15 ± 3.61, %non-Hispanic White = 46.3) completed gait, Clinical Dementia Rating Scale (CDR), and SCC assessment at baseline and annual follow-up (Mfollow-up = 3.5). Forty-two participants met slow gait criteria at baseline. Generalized linear mixed-effects models examined baseline SCC to predict cognitive impairment on CDR over follow-up.ResultsWe reviewed all published MCR studies (N = 106) and documented ambiguity in SCC criteria, with a prevalent approach being use of a single self-reported memory item. In EAS, high SCC endorsement on a comprehensive, validated screen significantly affected the rate of cognitive impairment (CDR; βinteraction = 0.039, p = .018) in slow gait individuals.ConclusionsAn assessment approach that queries across numerous SCC domains was found to predict future decline in clinical dementia status in slow gait older adults. Current SCC practices in MCR, which tend to utilize a single-memory item, may not be the optimal approach. We discuss the implications of SCC criteria validation and standardization to enhance early dementia detection in MCR.
| S-EPMC10943500 | biostudies-literature
Project description:BackgroundMotoric cognitive risk (MCR) syndrome is a predementia syndrome characterized by subjective cognitive complaints and slow gait in the absence of dementia and mobility disability. Although past research has suggested that personality traits could play a significant role in the onset and progression of MCR among older adults, the exact relationships between specific personality profiles and MCR remain unclear. This study aimed to examine the relationship between personality profiles and MCR among community-dwelling older adults.MethodsA cross-sectional study was conducted from March 2021 to January 2022. Personality traits, including openness, extraversion, agreeableness, conscientiousness and neuroticism, were measured using the 40-item brief version of the Chinese Big Five Inventory. The Latent profile analysis was used to identify personality profiles among these older adults who shared similar patterns of personality traits. The Lanza, Tan, and Bray's approach was employed to investigate the personality profile-specific differences in MCR prevalence. Furthermore, a stepwise multinomial logistic regression revealed unique population characteristics for different personality profiles.ResultsA total of 538 eligible participants were included in this study. The mean age was 73.25 years (SD = 9.0) and 62.50% were females. This study identified four distinct personality profiles: the resilient, ordinary, reserved, and anti-resilient profiles. The resilient profile exhibited the lowest prevalence of MCR (mean = 6%, SE = 0.024), whereas the anti-resilient profile had the highest (mean = 20.3%, SE = 0.043). The prevalence of MCR differed among personality profiles (overall χ2 = 14.599, p = 0.002). Personality profile membership was characterized by different population characteristics. Notably, the anti-resilient profile was association with symptoms of depression (OR = 28.443, 95%CI = 11.095-72.912), while the reserved profile was linked with advanced age (OR = 1.031, 95%CI = 1.003-1.061). Overall, a low education level and poor sleep quality were the robust attribution factors.ConclusionsThis study revealed that personality profiles may assist in identifying older adults at greater risk of MCR. Increased awareness and management of personality profiles may contribute to the prevention of MCR.
| S-EPMC11874118 | biostudies-literature
Project description:ImportanceMotoric cognitive risk (MCR) is a novel predementia syndrome; however, whether it can estimate dementia in a nationwide population or has additive estimation validity over cognitive or motoric components alone remains unknown.ObjectiveTo examine whether modified MCR, which incorporates the timed-up-and-go and one-leg-standing tests, improves estimation validity for incident dementia over using cognitive or motoric components alone.Design, setting, and participantsThis nationwide cohort study evaluated data from individuals aged 66 years who participated in the National Screening Program for Transitional Ages in Korea from January 1, 2009, to December 31, 2013, and examined the association between MCR and incident dementia using Cox proportional hazards regression analysis. Data were collected from the index date (the date on which the participant had the screening) until dementia onset, death, or the end of the follow-up period, whichever came first. The 2 subtypes were defined as subjective cognitive declines with timed-up-and-go impairment or one-leg-standing impairment. The data set was generated with permission from the Korean National Health Insurance Service, and data analysis was conducted from August 2, 2021, to January 31, 2022. Individuals diagnosed with dementia or psychotic disorders or those who had a documented history of dementia medication use before the index date were excluded.Main outcomes and measuresThe main outcome was incidence of dementia, defined as an individual receiving their first dementia medication with the relevant International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes after the index date.ResultsAmong the 1 137 530 participants (53.7% women), 15 380 (1.4%) met the MCR criteria for the timed-up-and-go subtype, and 32 910 (2.9%) met the criteria for the one-leg-standing subtype. The mean (SD) follow-up period was 7.02 (1.38) years. Participants with MCR demonstrated an approximately 2-fold higher risk of incident dementia than those without MCR (timed-up-and-go subtype, adjusted hazard ratio, 2.03; 95% CI, 1.94-2.13; one-leg-standing subtype, adjusted hazard ratio, 2.05; 95% CI, 1.98-2.12).Conclusions and relevanceIn this cohort study of participants aged 66 years of the National Screening Program for Transitional Ages, modified motoric cognitive risk had higher adjusted hazard ratios of incident dementia than individual cognitive or motoric components. Motoric cognitive risk may be a practical screening tool for estimating dementia among individuals in their mid-60s ; however, further investigation of the clinical and neurobiological aspects is necessary.
| S-EPMC10587785 | biostudies-literature
Project description:Background: Motoric cognitive risk (MCR) syndrome is considered to be a pre-dementia syndrome. Although an increasing number of studies have begun to focus on this syndrome, few investigations have been launched in China. This study was performed to examine the prevalence and correlates of MCR in China. Methods: We included 5,725 adults aged over 60 years from China Health and Retirement Longitudinal Study (CHARLS). MCR was defined as the presence of subjective cognitive complaints and a gait speed ≤20th percentile of the weighted population distribution adjusted for sex and height. The associations among selected modifiable associated factors and clinical measures with MCR were examined using multivariate logistic regression analysis. Results: Of the participants, 414 met the criteria for MCR with an overall prevalence 7.29% (95% CI: 6.62-7.96%). MCR was found to be more prevalent among women than men (9.73 vs 4.85%), and more prevalent among participants ≥75 years than those <75 years (7.85 vs 5.23%). After multivariable adjustment, lower or upper extremity functional limitations, activities of daily living (ADL) disabilities, weak grip strength, exhaustion, and history of hypertension were found to be significantly associated with MCR. The multivariate analysis also showed higher levels of cystatin C and C-reactive protein were associated with increased odds for MCR. Conclusions: The present study showed that MCR syndrome is highly prevalent among Chinese community-dwelling older adults, and revealed several factors that were correlated with MCR. Longitudinal studies are warranted to further explore the modifiable risk factors of MCR.
| S-EPMC9261413 | biostudies-literature
Project description:ObjectiveThe objective of this study was to develop a risk prediction model for motoric cognitive risk syndrome (MCR) in older adults.MethodsParticipants were selected from the 2015 China Health and Retirement Longitudinal Study database and randomly assigned to the training group and the validation group, with proportions of 70% and 30%, respectively. LASSO regression analysis was used to screen the predictors. Then, identified predictors were included in multivariate logistic regression analysis and used to construct model nomogram. The performance of the model was evaluated by area under the receiver operating characteristic (ROC) curve (AUC), calibration curves and decision curve analysis (DCA).Results528 out of 3962 participants (13.3%) developed MCR. Multivariate logistic regression analysis showed that weakness, chronic pain, limb dysfunction score, visual acuity score and Five-Times-Sit-To-Stand test were predictors of MCR in older adults. Using these factors, a nomogram model was constructed. The AUC values for the training and validation sets of the predictive model were 0.735 (95% CI = 0.708-0.763) and 0.745 (95% CI = 0.705-0.785), respectively.ConclusionThe nomogram constructed in this study is a useful tool for assessing the risk of MCR in older adults, which can help clinicians identify individuals at high risk.
| S-EPMC11246282 | biostudies-literature
Project description:IntroductionMotoric cognitive risk syndrome (MCR) is characterized by subjective cognitive complaints (SCCs) and slow gait (SG). Metabolomics and lipidomics may potentiate disclosure of the underlying mechanisms of MCR.MethodsThis was a cross-sectional study from the West China Health and Aging Trend cohort study (WCHAT). The operational definition of MCR is the presence of SCCs and SG without dementia or mobility disability. The test and analysis were based on untargeted metabolomics and lipidomics, consensus clustering, lasso regression and 10-fold cross-validation.ResultsThis study enrolled 6,031 individuals for clinical analysis and 577 plasma samples for omics analysis. The overall prevalence of MCR was 9.7%, and the prevalence of MCR-only, assessed cognitive impairment-only (CI-only) and MCR-CI were 7.5, 13.3, and 2.1%, respectively. By consensus clustering analysis, MCR-only was clustered into three metabolic subtypes, MCR-I, MCR-II and MCR-III. Clinically, body fat mass (OR = 0.89, CI = 0.82-0.96) was negatively correlated with MCR-I, and comorbidity (OR = 2.19, CI = 1.10-4.38) was positively correlated with MCR-III. Diabetes mellitus had the highest ORs above 1 in MCR-II and MCR-III (OR = 3.18, CI = 1.02-9.91; OR = 2.83, CI = 1.33-6.04, respectively). The risk metabolites of MCR-III showed relatively high similarity with those of cognitive impairment. Notably, L-proline, L-cystine, ADMA, and N1-acetylspermidine were significantly changed in MCR-only, and PC(40:3), SM(32:1), TG(51:3), eicosanoic acid(20:1), methyl-D-galactoside and TG(50:3) contributed most to the prediction model for MCR-III.InterpretationPre-dementia syndrome of MCR has distinct metabolic subtypes, and SCCs and SG may cause different metabolic changes to develop MCR.
| S-EPMC9490321 | biostudies-literature
Project description:Peak expiratory flow (PEF) has been linked to several health-related outcomes in older people, but its association with frailty is still unclear. This study investigates the association between PEF and prevalent and incident frailty in older adults. Data come from 2559 community-dwelling participants (age ≥ 60 years) of the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Baseline PEF was expressed as standardized residual (SR) percentiles. Frailty was assessed at baseline and over six years, according to the Fried criteria. Associations between PEF and frailty were estimated cross-sectionally through logistic regressions, and longitudinally by multinomial logistic regression, considering death as alternative outcome. Obstructive respiratory diseases and smoking habits were treated as potential effect modifiers. Our cross-sectional results showed that the 10th-49th and <10th PEF SR percentile categories were associated with three- and five-fold higher likelihood of being frail than the 80th-100th category. Similar estimates were confirmed longitudinally, i.e., adjusted OR = 3.11 (95% CI: 1.61-6.01) for PEF SR percentiles < 10th, compared with 80th-100th percentiles. Associations were enounced in participants without physical deficits, and tended to be stronger among those with baseline obstructive respiratory diseases, and, longitudinally, also among former/current smokers. These findings suggest that PEF is a marker of general robustness in older adults, and its reduction exceeding that expected by age is associated with frailty development.
| S-EPMC6912606 | biostudies-literature