Association of Motoric Cognitive Risk Syndrome with Cardiovascular Disease and Risk Factors: Results from an Original Study and Meta-Analysis

Article type: Research Article

Authors: Beauchet, Olivier^{a; b; c; *} | Sekhon, Harmehr^{a; d} | Barden, John^e | Liu-Ambrose, Teresa^f | Chester, Victoria L.^g | Szturm, Tony^h | Grenier, Sébastienⁱ | Léonard, Guillaume^j | Bherer, Louis^{i; k} | Allali, Gilles^l | Canadian Gait Consortium

Correspondence: [*] Correspondence to: Olivier Beauchet, MD, PhD, Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, 3755 chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1E2, Canada. Tel.: +1 514 340 8222/Ext. 4765; Fax: +1 514 340 7547; E-mail: [email protected]

Abstract: Background:Motoric cognitive risk (MCR) syndrome, a recently described pre-dementia syndrome, has been associated with cardiovascular disease and their risk factors (CVDRF). Objective:To determine whether MCR syndrome was associated with CVDRF in French community-dwelling older adults, and to quantitatively evaluate, with a systematic review and meta-analysis, the association of MCR syndrome with CVDRF. Methods:Based on a cross-sectional design, 238 older adults without dementia were selected from the French GAIT study. An English and French systematic Medline and Embase search (without limiting date of publication) was also conducted in February 2017 using the terms “motoric cognitive risk syndrome” OR “motoric cognitive risk” OR “motoric risk”. The systematic review and meta-analysis included 8 studies. CVDRF were defined as cardiovascular diseases, hypertension, diabetes, stroke, obesity and abnormal waist-hip ratio (WHR). Results:The prevalence of MCR syndrome in the current original study was 16.8%. MCR syndrome was associated with abnormalWHR(Odds ratio [OR] >2.8 with p < 0.020) and high blood pressure (OR >2.5 with p < 0.025). Of the 202 originally identified abstracts, 7 (3.5%) were selected for the systematic review. The meta-analysis showed that all pooled OR were significant with a p-value <0.001 (OR = 1.41 for cardiovascular diseases, 1.21 for hypertension, 1.44 for diabetes, 2.05 for stroke, and 1.34 for obesity). When pooling all CVDRF, the overall OR was 1.38 (95% CI, 1.33–1.45) with p-value <0.001. Conclusion:MCR syndrome is significantly associated with CVDRF. These findings suggest that a vascular mechanism may underlie the pathophysiology of MCR syndrome.

Keywords: Cognitive disorders, gait disorders, meta-analysis, prediction

DOI: 10.3233/JAD-180203

Journal: Journal of Alzheimer's Disease, vol. 64, no. 3, pp. 875-887, 2018