Gait Dysfunction in Motoric Cognitive Risk Syndrome.
Cognition
gait
motoric cognitive risk syndrome
Journal
Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863
Informations de publication
Date de publication:
2019
2019
Historique:
pubmed:
26
3
2019
medline:
21
10
2020
entrez:
26
3
2019
Statut:
ppublish
Résumé
Motoric cognitive risk (MCR) syndrome is a cognitive-motor syndrome associated with increased risk of transition to dementia. The clinical phenotype of MCR is not yet established. To systematically assess clinical gait abnormalities in older adults with MCR. Of the 522 community-dwelling non-demented adults aged 65 and older enrolled in the Central Control of Mobility in Aging study, 43 were diagnosed with MCR (47% women) based on presence of cognitive complaints and slow gait velocity (MCRv). Four additional subtypes of MCR were defined by substituting slow gait with short stride length (MCRsl, n = 41), slow swing time (MCRsw, n = 21), high stride length variability (MCRslv, n = 24), and high swing time variability (MCRswv, n = 25). The prevalence of clinical gait abnormalities (neurological or non-neurological) in MCR overall (n = 81) and subtypes was studied. We also examined if gait abnormalities predicted further cognitive and functional decline in MCR cases. Most clinical gait abnormalities were mild (walked without assistance) in the five MCR subtypes (44 to 61%). Neurological (range 24 to 46%) and non-neurological gait abnormalities (33 to 61%) were common in all MCR subtypes. Neurological gaits were most frequent in MCRsl (46%) and non-neurological gaits in MCRv (61%). Over a median 3.02 years of follow-up, presence of gait abnormality in MCR cases at baseline predicted worsening disability scores (estimate 0.17, p-value = 0.033) but not decline on cognitive scores (p-value = 0.056). Clinical gait abnormalities are common in MCR syndrome and its subtypes, and are associated with accelerated functional decline.
Sections du résumé
BACKGROUND
Motoric cognitive risk (MCR) syndrome is a cognitive-motor syndrome associated with increased risk of transition to dementia. The clinical phenotype of MCR is not yet established.
OBJECTIVE
To systematically assess clinical gait abnormalities in older adults with MCR.
METHODS
Of the 522 community-dwelling non-demented adults aged 65 and older enrolled in the Central Control of Mobility in Aging study, 43 were diagnosed with MCR (47% women) based on presence of cognitive complaints and slow gait velocity (MCRv). Four additional subtypes of MCR were defined by substituting slow gait with short stride length (MCRsl, n = 41), slow swing time (MCRsw, n = 21), high stride length variability (MCRslv, n = 24), and high swing time variability (MCRswv, n = 25). The prevalence of clinical gait abnormalities (neurological or non-neurological) in MCR overall (n = 81) and subtypes was studied. We also examined if gait abnormalities predicted further cognitive and functional decline in MCR cases.
RESULTS
Most clinical gait abnormalities were mild (walked without assistance) in the five MCR subtypes (44 to 61%). Neurological (range 24 to 46%) and non-neurological gait abnormalities (33 to 61%) were common in all MCR subtypes. Neurological gaits were most frequent in MCRsl (46%) and non-neurological gaits in MCRv (61%). Over a median 3.02 years of follow-up, presence of gait abnormality in MCR cases at baseline predicted worsening disability scores (estimate 0.17, p-value = 0.033) but not decline on cognitive scores (p-value = 0.056).
CONCLUSION
Clinical gait abnormalities are common in MCR syndrome and its subtypes, and are associated with accelerated functional decline.
Identifiants
pubmed: 30909242
pii: JAD181227
doi: 10.3233/JAD-181227
pmc: PMC7764990
mid: NIHMS1655389
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
S95-S103Subventions
Organisme : NIA NIH HHS
ID : R01 AG036921
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG044007
Pays : United States
Organisme : NIA NIH HHS
ID : R56 AG057548
Pays : United States
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