Risk factors for the progression of motoric cognitive risk syndrome to dementia: Retrospective cohort analysis of two populations
Zeev Meiner
Department of Physical Medicine and Rehabilitation, Hadassah Mount Scopus, Jerusalem, Israel
Contribution: Data curation (equal), Investigation (equal), Methodology (equal), Project administration (supporting), Supervision (equal), Validation (equal), Writing - original draft (lead)
Search for more papers by this authorEmmeline Ayers
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
Contribution: Conceptualization (supporting), Data curation (equal), Formal analysis (lead), Investigation (supporting), Methodology (equal), Project administration (lead), Resources (equal), Software (lead), Supervision (supporting), Writing - review & editing (supporting)
Search for more papers by this authorDavid A. Bennett
Department of Neurology, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
Contribution: Data curation (lead), Formal analysis (supporting), Funding acquisition (lead), Methodology (supporting), Project administration (lead), Resources (lead), Supervision (supporting), Validation (supporting), Visualization, Writing - review & editing (equal)
Search for more papers by this authorCuiling Wang
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
Contribution: Data curation (supporting), Formal analysis (lead), Investigation (supporting), Methodology (supporting), Software (equal), Supervision (supporting), Validation (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Joe Verghese
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
Correspondence
Joe Verghese, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Email: [email protected]
Contribution: Conceptualization (equal), Data curation (supporting), Funding acquisition (supporting), Investigation (equal), Project administration (equal), Supervision (equal), Validation (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorZeev Meiner
Department of Physical Medicine and Rehabilitation, Hadassah Mount Scopus, Jerusalem, Israel
Contribution: Data curation (equal), Investigation (equal), Methodology (equal), Project administration (supporting), Supervision (equal), Validation (equal), Writing - original draft (lead)
Search for more papers by this authorEmmeline Ayers
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
Contribution: Conceptualization (supporting), Data curation (equal), Formal analysis (lead), Investigation (supporting), Methodology (equal), Project administration (lead), Resources (equal), Software (lead), Supervision (supporting), Writing - review & editing (supporting)
Search for more papers by this authorDavid A. Bennett
Department of Neurology, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
Contribution: Data curation (lead), Formal analysis (supporting), Funding acquisition (lead), Methodology (supporting), Project administration (lead), Resources (lead), Supervision (supporting), Validation (supporting), Visualization, Writing - review & editing (equal)
Search for more papers by this authorCuiling Wang
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
Contribution: Data curation (supporting), Formal analysis (lead), Investigation (supporting), Methodology (supporting), Software (equal), Supervision (supporting), Validation (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Joe Verghese
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
Correspondence
Joe Verghese, Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Email: [email protected]
Contribution: Conceptualization (equal), Data curation (supporting), Funding acquisition (supporting), Investigation (equal), Project administration (equal), Supervision (equal), Validation (equal), Visualization (equal), Writing - review & editing (equal)
Search for more papers by this authorAbstract
Background and purpose
Motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by cognitive complaints and slow gait. MCR is associated with increased risk of cognitive decline and incident dementia. Predictors of transition to dementia in MCR patients are still obscure.
Methods
We examined clinical, biological and lifestyle parameters related to conversion to dementia using Cox models in 439 older adults with prevalent MCR (mean age 79.87 ± 8.13 years, 70% women) from two cohorts, 268 from the Chicago-based Rush Memory and Aging project (MAP) and 171 from the Religious Orders Study (ROS), which enrolled religious clergy across the United States.
Results
In the pooled sample, 439 (13.2%) had prevalent MCR (268 MAP and 171 ROS). There were 140 (31.9%) incident dementia cases over a median follow up of 4.0 years. Age predicted conversion from MCR to dementia in both cohorts. Male gender was a risk factor only in ROS. In the pooled data, only higher depressive symptoms were associated with higher risk of conversion to dementia (adjusted hazard ratio [aHR] 1.13, 95% CI 1.03–1.24). Lower cognitive activity participation (aHR 0.59, 95% CI 0.44–0.79) and apolipoprotein E ε4 allele (aHR 2.57, 95% CI 1.48–4.45) predicted conversion to dementia in MAP.
Conclusions
Depressive symptoms and other cohort-specific risk factors were identified as predictors of transition to dementia in individuals with MCR. These findings suggest common pathological mechanisms underlying mood, gait and cognitive declines in aging, which could help develop preventive strategies.
CONFLICT OF INTEREST
None.
Open Research
DATA AVAILABILITY STATEMENT
All data included in these analyses are available via the Rush Alzheimer's Disease Center Research Resource Sharing Hub, which can be found at https://www.radc.rush.edu. It has descriptions of the studies and variables and a dynamic query function to aid searches for data and biospecimens for selected data. There is a login, after which any qualified investigator can submit requests for deidentified data.
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