Motoric Cognitive Risk Syndrome and Falls Risk: A Multi-Center Study

Article type: Research Article

Authors: Callisaya, Michele L.^{a; b; *} | Ayers, Emmeline^c | Barzilai, Nir^d | Ferrucci, Luigi^e | Guralnik, Jack M.^f | Lipton, Richard B.^{c; g} | Otahal, Petr^a | Srikanth, Velandai K.^{a; b} | Verghese, Joe^{c; d}

Affiliations: [a] Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia | [b] Department of Medicine, Stroke and Ageing Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia | [c] Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA | [d] Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA | [e] Longitudinal Studies Section, Clinical Research Branch, Gerontology Research Center, National Institute on Aging, Baltimore, MD, USA | [f] Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore, USA | [g] Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

Correspondence: [*] Correspondence to: Michele Callisaya, PhD, Menzies Institute for Medical Research, University of Tasmania, Liverpool Street, Hobart, TAS, Australia. Tel.: +61 3 62264785; E-mail: [email protected].

Abstract: Background: The Motoric Cognitive Risk Syndrome (MCR) is characterized by slow gait speed and cognitive complaints. Objectives: The objective of this study was to determine if the presence of MCR increases the risk of falls in older people. Methods: Individual participant data (n = 6,204) from five longitudinal studies from three countries were used for this analysis. MCR diagnosis was defined as both the presence of objectively measured slow gait speed and subjective cognitive complaints in those without dementia or mobility disability. Falls were prospectively ascertained using phone calls or questionnaires. Log binomial regression was performed to determine if MCR increased the risk of falls separately in each cohort. Random effects meta-analysis was used to pool results from all cohorts. Results: The mean age of participants was 74.9 (SD 6.8) years and 44% (n = 2728) were male. Overall 33.9% (n = 2104) reported a fall over follow-up. Pooled relative risk of MCR with any falls was RR 1.44 95% CI 1.16, 1.79. The components of MCR, slow gait (RR 1.30 95% CI 1.14, 1.47) and cognitive complaint (RR 1.25, 95% CI 1.07, 1.46) were also associated with an increased risk of any falls. In sub-analyses MCR was associated with any fall independent of previous falls (RR 1.29 95% CI 1.09, 1.53) and with multiple falls (RR 1.77, 95% CI 1.25, 2.51). Conclusion: MCR is associated with an increased risk of falls. The increase in risk was higher than for its individual components. The simplicity of the MCR makes it an attractive falls risk screening tool for the clinic.

Keywords: Cognition, dementia, falls, gait

DOI: 10.3233/JAD-160230

Journal: Journal of Alzheimer's Disease, vol. 53, no. 3, pp. 1043-1052, 2016