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Wang J, Liu Y, Jin R, Zhao X, Wu Z, Han Z, Xu Z, Guo X, Tao L. Intraindividual difference in estimated GFR by creatinine and cystatin C, cognitive trajectories and motoric cognitive risk syndrome. Nephrol Dial Transplant 2024; 39:860-872. [PMID: 37930847 DOI: 10.1093/ndt/gfad234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Intraindividual differences between estimated glomerular filtration rate (eGFR) based on cystatin C (eGFRcys) and creatinine (eGFRcr) can convey important clinical information regarding health status. However, the clinical implications of these differences (eGFRdiff) for risk of cognitive decline and motoric cognitive risk (MCR) syndrome remains unclear. We aimed to investigate the longitudinal associations of eGFRdiff with cognitive trajectories and incident MCR. METHODS Based on the China Health and Retirement Longitudinal Study, we identified two study subcohorts: one for cognitive trajectory follow-up (6423 participants, 2011-2018) and another for incident MCR follow-up (2477 participants, 2011-2015). The eGFRdiff was defined as eGFRcys - eGFRcr. Adjusted ordinal and binary logistic regression models were separately used to assess the associations of eGFRdiff with cognitive trajectories and incident MCR. We also performed discordance analyses for eGFRdiff versus eGFRcys, eGFRcr or eGFR based on both creatinine and cystatin C (eGFRcys-cr). RESULTS In the first subcohort, four distinct 7-year cognitive trajectories were identified. Each 1 standard deviation (SD) higher eGFRdiff (value for eGFRcys - eGFRcr) was associated with a lower risk of poorer cognitive trajectories {odds ratio 0.909 [95% confidence interval (CI) 0.877-0.942]}. In the second subcohort, 121 participants developed incident MCR after a 4-year follow-up. Each 1-SD higher eGFRdiff (value for eGFRcys - eGFRcr) was linked with a 25.3% (95% CI 16.6-33.2) decreased risk for MCR. The above associations persisted in individuals with normal kidney function. Additionally, the risk for cognitive decline and incident MCR was more strongly associated with eGFRcys than eGFRcr and eGFRcys-cr. For the discordance analyses, the 'discordantly high eGFRdiff/low eGFR' group but not the 'discordantly low eGFRdiff/high eGFR' exhibited a significantly lower risk of poorer cognitive trajectories and MCR compared with the concordant group. CONCLUSIONS A large negative difference between eGFRcys and eGFRcr (eGFRcys < eGFRcr) was associated with a higher risk of cognitive decline and incident MCR. The eGFRdiff could capture additional valuable risk information beyond eGFRcys, eGFRcr and eGFRcys-cr.
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Affiliation(s)
- Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Yueruijing Liu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Rui Jin
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xiaoyu Zhao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Department of Public Health, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Ze Han
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Zongkai Xu
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
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Zhang H, Hu Z, Jiang S, Hao M, Li Y, Liu Y, Jiang X, Jin L, Wang X. Social frailty and the incidence of motoric cognitive risk syndrome in older adults. Alzheimers Dement 2024; 20:2329-2339. [PMID: 38284799 PMCID: PMC11032557 DOI: 10.1002/alz.13696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Various associations between social factors and motoric cognitive risk syndrome (MCR) have been reported. However, whether social frailty (integrated from multiple social factors) is associated with MCR is still unclear. METHODS We included 4657 individuals without MCR at Round 1 of the NHATS as the discovery sample, and 3075 newly recruited individuals from Round 5 of the NHATS as the independent validation sample. Social frailty was assessed by five social items. MCR was defined as the presence of both subjective cognitive complaints and slow gait speed in individuals without dementia or mobility disability. RESULTS Compared with normal individuals, those with social frailty had higher risk of incident MCR (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.34-1.84). Each additional unfavorable social item was associated with an increased risk of MCR (HR: 1.32, 95% CI: 1.22-1.43). DISCUSSION Social frailty was associated with an increased risk of incident MCR in older adults. HIGHLIGHTS Various associations between social factors and motoric cognitive risk syndrome (MCR) have been reported. Social frailty that integrated from multiple social factors was associated with an increased risk of incident MCR. Social frailty should be included in the early screening of individuals to identify those at higher risk of MCR.
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Affiliation(s)
- Hui Zhang
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Zixin Hu
- Artificial Intelligence Innovation and Incubation InstituteFudan UniversityShanghaiChina
| | - Shuai Jiang
- Department of Vascular SurgeryShanghai Key Laboratory of Vascular Lesion Regulation and RemodelingShanghai Pudong HospitalFudan University Pudong Medical CenterShanghaiChina
| | - Meng Hao
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Yi Li
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Yining Liu
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Xiao‐Yan Jiang
- State Key Laboratory of CardiologyDepartment of Pathology and PathophysiologySchool of MedicineTongji UniversityShanghaiChina
| | - Li Jin
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Xiaofeng Wang
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
- National Clinical Research Centre for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
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Zhang H, Jiang S, Hao M, Li Y, Hu Z, Jiang X, Jin L, Wang X. Association of cardiometabolic multimorbidity with motoric cognitive risk syndrome in older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12491. [PMID: 37937160 PMCID: PMC10626031 DOI: 10.1002/dad2.12491] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION Motoric 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. METHODS We 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). RESULTS CMM 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). DISCUSSION CMM is associated with an increased risk of MCR in older adults. HIGHLIGHTS Motoric 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.
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Affiliation(s)
- Hui Zhang
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
- Department of Vascular SurgeryShanghai Key Laboratory of Vascular Lesion Regulation and RemodelingShanghai Pudong HospitalFudan University Pudong Medical CenterShanghaiChina
| | - Shuai Jiang
- Department of Vascular SurgeryShanghai Key Laboratory of Vascular Lesion Regulation and RemodelingShanghai Pudong HospitalFudan University Pudong Medical CenterShanghaiChina
| | - Meng Hao
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Yi Li
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Zixin Hu
- Artificial Intelligence Innovation and Incubation InstituteFudan UniversityShanghaiChina
| | - Xiao‐Yan Jiang
- State Key Laboratory of CardiologyDepartment of Pathology and PathophysiologySchool of MedicineTongji UniversityShanghaiChina
| | - Li Jin
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
| | - Xiaofeng Wang
- Human Phenome InstituteZhangjiang Fudan International Innovation CentreFudan UniversityShanghaiChina
- National Clinical Research Centre for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
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Mullin DS, Gadd D, Russ TC, Luciano M, Muniz-Terrera G. Motoric cognitive risk syndrome trajectories and incident dementia over 10 years. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100178. [PMID: 38162293 PMCID: PMC10757175 DOI: 10.1016/j.cccb.2023.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/25/2023] [Accepted: 07/29/2023] [Indexed: 01/03/2024]
Abstract
Background Motoric Cognitive Risk (MCR) syndrome is a high-risk state for adverse health outcomes in older adults characterised by measured slow gait speed and self-reported cognitive complaints. The recent addition to the Lothian Birth Cohort 1936 of robust dementia outcomes enabled us to assess the prognostic value of MCR for dementia and explore the various trajectories of participants diagnosed with MCR. Methods We classified 680 community-dwelling participants free from dementia into non-MCR or MCR groups at mean [SD] age 76.3 [0.8] years. We used Cox and competing risk regression methods, adjusted for potential confounders, to evaluate the risk of developing all-cause incident dementia over 10 years of follow-up. Secondarily, we followed the trajectories for individuals with and without MCR at baseline and categorised them into subgroups based on whether MCR was still present at the next research wave, three years later. Results The presence of MCR increased the risk of incident dementia (adjusted HR 2.34, 95%CI 1.14-4.78, p = 0.020), as did fewer years of education and higher depression symptoms. However, MCR has a heterogenous progression trajectory. The MCR progression subgroups each have different prognostic values for incident dementia. Conclusion MCR showed similar prognostic ability for dementia in a Scottish cohort as for other populations. MCR could identify a target group for early interventions of modifiable risk factors to prevent incident dementia. This study illustrates the heterogeneous nature of MCR progression. Exploring the underlying reasons will be important work in future work.
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Affiliation(s)
- Donncha S. Mullin
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, United Kingdom
- Edinburgh Dementia Prevention Group, University of Edinburgh, United Kingdom
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
- NHS Lothian, Royal Edinburgh Hospital, Edinburgh, United Kingdom
| | - Danni Gadd
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, United Kingdom
- Optima Partners, Edinburgh EH2 4HQ, United Kingdom
| | - Tom C. Russ
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, United Kingdom
- Edinburgh Dementia Prevention Group, University of Edinburgh, United Kingdom
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
- NHS Lothian, Royal Edinburgh Hospital, Edinburgh, United Kingdom
- Department of Psychology, Lothian Birth Cohorts, University of Edinburgh, United Kingdom
| | - Michelle Luciano
- Department of Psychology, Lothian Birth Cohorts, University of Edinburgh, United Kingdom
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention Group, University of Edinburgh, United Kingdom
- Ohio University Osteopathic College of Medicine, Ohio University, USA
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Yao G, Luo Y, Wu H, Gao M, Sun J. Association between positive control in self-perceptions of aging and motoric cognitive risk syndrome among Chinese community-dwelling older adults: a cross-sectional study. BMC Geriatr 2023; 23:211. [PMID: 37009878 PMCID: PMC10069104 DOI: 10.1186/s12877-023-03934-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 03/26/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Self-perceptions of aging (SPA) are important psychosocial factors that lead to a wide range of outcomes including dementia. However, the relationships between positive SPA and motoric cognitive risk syndrome (MCR) which is a predementia syndrome are still unknown. This study aimed to reveal the associations of positive control and aging awareness of SPA with the risk of MCR and its components. METHODS A cross-sectional design was conducted among 1137 Chinese community-dwelling older adults. Positive control and aging awareness were defined by two dimensions of SPA (Positive control and Timeline chronic). MCR was determined according to definition. Multivariable logistic regression was used to examine the associations. RESULTS The overall prevalence of MCR was 11.5% (mean age = 71.62 ± 5.22). After adjusting for depression, anxiety, and cognitive function, positive control was associated with reduced risk of MCR (OR = 0.624, 95% CI 0.402-0.969, P = 0.036), subjective cognitive complaints (SCC) (OR = 0.687, 95% CI 0.492-0.959, P = 0.027), and gait speed (GS) (OR = 0.377, 95% CI 0.197-0.720, P = 0.003), respectively. Aging awareness was merely related to increased risk of MCR (OR = 1.386, 95% CI 1.062-1.810, P = 0.016). CONCLUSIONS This study highlights the crucial associations of positive control and aging awareness with MCR and its components. Our results emphasize that positive belief in control and adaptive aging awareness might be promising targets for preventing MCR.
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Affiliation(s)
- Guiying Yao
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China
| | - Yanyan Luo
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China.
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China.
| | - Huimin Wu
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- School of Nursing, SIAS University, Xinzheng, Henan, 451150, People's Republic of China
| | - Min Gao
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China
| | - Junjun Sun
- School of Nursing, Xinxiang Medical University, 601 Jinsui Road, Xinxiang, 453003, Henan, China
- Xinxiang Key Laboratory for Chronic Disease Basic Research and Intelligent Care, Xinxiang, Henan, 453003, People's Republic of China
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Wen ZF, Peng SH, Wang JL, Wang HY, Yang LP, Liu Q, Zhang XG. Prevalence of motoric cognitive risk syndrome among older adults: a systematic review and meta-analysis. Aging Ment Health 2022:1-13. [PMID: 36533320 DOI: 10.1080/13607863.2022.2158305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome. Several studies on the prevalence of MCR have been published; however, the data vary across studies with different epidemiological characteristics. Thus, this study aimed to quantitatively analyse the overall prevalence and associated epidemiological characteristics of MCR among older adults aged ≥ 60 years. METHODS The Cochrane Library, PubMed, Web of Science, CINAHL, Embase, Scopus, PsycInfo, China National Knowledge Infrastructure, Weipu Database, China Biology Medicine disc and Wanfang Database were searched from their inception to January 2022. A modified Newcastle-Ottawa Scale evaluated the risk of bias. Statistical heterogeneity among the included studies was analysed using Cochran's Q and I2 tests. A random effect model calculated pooled prevalence owing to study heterogeneity. Begg's and Egger's tests were used to assess the publication bias. Additionally, subgroup analysis and meta-regression were performed based on different epidemiological characteristics to determine heterogeneity sources. RESULTS Sixty-two studies comprising 187,558 samples were obtained. The pooled MCR prevalence was 9.0% (95% confidence interval: 8.3-9.8). A higher MCR prevalence was observed in females, older adults with a low educational level, depression and cardiovascular risk factors, South American populations, and studies with small sample sizes and cross-section designs. Furthermore, subjective cognitive complaint using scale score and gait speed using instrument gait showed higher MCR prevalence. CONCLUSION MCR is common in older adults, and various epidemiological characteristics influence its prevalence. Thus, preventive measures are required for older adults with higher MCR prevalence.
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Affiliation(s)
- Zhi-Fei Wen
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Si-Han Peng
- School Clinical, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Jia-Lin Wang
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Hong-Yan Wang
- Dean Office, Sichuan Nursing Vocational College, Sichuan, China
| | - Li-Ping Yang
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Qin Liu
- School of Nursing, Chengdu university of Traditional Chinese Medicine, Sichuan, China
| | - Xian-Geng Zhang
- Dean Office, Sichuan Nursing Vocational College, Sichuan, China
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Chen PH, Lin SI, Liao YY, Hsu WL, Cheng FY. Associations between blood-based biomarkers of Alzheimer's disease with cognition in motoric cognitive risk syndrome: A pilot study using plasma Aβ42 and total tau. Front Aging Neurosci 2022; 14:981632. [PMID: 36268195 PMCID: PMC9577229 DOI: 10.3389/fnagi.2022.981632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/20/2022] [Indexed: 01/28/2023] Open
Abstract
Background Motoric cognitive risk (MCR) syndrome is a conceptual construct that combines slow gait speed with subjective cognitive complaints and has been shown to be associated with an increased risk of developing dementia. However, the relationships between the pathology of Alzheimer's disease (AD) and MCR syndrome remain uncertain. Therefore, the purpose of this study was to determine the levels of plasma AD biomarkers (Aβ42 and total tau) and their relationships with cognition in individuals with MCR. Materials and methods This was a cross-sectional pilot study that enrolled 25 individuals with normal cognition (NC), 27 with MCR, and 16 with AD. Plasma Aβ42 and total tau (t-tau) levels were measured using immunomagnetic reduction (IMR) assays. A comprehensive neuropsychological assessment was also performed. Results The levels of plasma t-tau proteins did not differ significantly between the MCR and AD groups, but that of plasma t-tau was significantly increased in the MCR and AD groups, compared to the NC group. Visuospatial performance was significantly lower in the MCR group than in the NC group. The levels of plasma t-tau correlated significantly with the Montreal Cognitive Assessment (MoCA) and Boston naming test scores in the MCR group. Conclusion In this pilot study, we found significantly increased plasma t-tau proteins in the MCR and AD groups, compared with the NC group. The plasma t-tau levels were also significantly correlated with the cognitive function of older adults with MCR. These results implied that MCR and AD may share similar pathology. However, these findings need further confirmation in longitudinal studies.
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Affiliation(s)
- Pei-Hao Chen
- Department of Neurology, MacKay Memorial Hospital, Taipei, Taiwan,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan,Graduate Institute of Mechanical and Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Sang-I Lin
- Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wei-Ling Hsu
- Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan,Center of Dementia Care, MacKay Memorial Hospital, New Taipei City, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan,*Correspondence: Fang-Yu Cheng,
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Xu W, Bai A, Liang Y, Lin Z. Association between depression and motoric cognitive risk syndrome among community-dwelling older adults in China: A 4-year prospective cohort study. Eur J Neurol 2022; 29:1377-1384. [PMID: 35098617 DOI: 10.1111/ene.15262] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Depression can lead to a wide range of adverse health outcomes, including dementia. However, evidence supporting the relationship between depression and motoric cognitive risk syndrome (MCR), a pre-dementia syndrome, remains lacking. This study aimed to examine the association between depression and MCR among community-dwelling Chinese older adults. METHODS Data were taken from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Depression was defined by a Center for Epidemiological Studies Depression Scale (CES-D) score ≥10. MCR was defined as subjective cognitive complaints and objective slow gait speed. Multivariate logistic regression analyses were conducted to examine the cross-sectional and longitudinal associations between depression and MCR at baseline and a 4-year follow-up period for the sample population and gender groups. RESULTS The prevalence of MCR was higher in participants with depression than in those without depression at baseline (12.2% vs. 8.9%; p = 0.001). Participants with depression at baseline had a higher 4-year incidence of MCR than those without depression (14.8% vs. 8.7%; p < 0.001). Both cross-sectional analysis (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.13-1.75) and prospective analysis (OR 1.95, 95% CI 1.56-2.44) demonstrated that depression was significantly associated with MCR. These associations were consistent across different gender groups and stronger among female individuals. CONCLUSIONS Depression is an independent risk factor for MCR among community-dwelling Chinese older adults. Special attention should be paid to the care of older people with depression to reduce the occurrence of MCR and even dementia.
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Affiliation(s)
- Weihao Xu
- Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Anying Bai
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanfeng Liang
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhanyi Lin
- Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Bommarito G, Garibotto V, Frisoni GB, Ribaldi F, Stampacchia S, Assal F, Armand S, Allali G, Griffa A. The Biological Substrate of the Motoric Cognitive Risk Syndrome: A Pilot Study Using Amyloid-/Tau-PET and MR Imaging. J Alzheimers Dis 2022; 87:1483-1490. [PMID: 35491777 PMCID: PMC9277684 DOI: 10.3233/jad-215461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We conducted a cross-sectional pilot study to explore the biological substrate of the Motoric Cognitive Risk (MCR) syndrome in a Memory Clinic cohort, using a multimodal imaging approach. Twenty participants were recruited and classified as MCR+/−. Amyloid- and tau-PET uptakes, temporal atrophy, white matter hyperintensities, lateral ventricular volume (LVV), and diffusion tensor parameters were compared between groups. No significant differences were found in imaging features related to Alzheimer’s disease or gross vascular damage. MCR+ patients had increased LVV and altered diffusion parameters in the superior corona radiata. Ventricular enlargement and microstructural damage of the surrounding white matter tracts could contribute to MCR pathophysiology.
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Affiliation(s)
- Giulia Bommarito
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals and NIMTlab, Geneva University, Geneva, Switzerland
| | - Giovanni B. Frisoni
- Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Federica Ribaldi
- Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Sara Stampacchia
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals and NIMTlab, Geneva University, Geneva, Switzerland
| | - Frédéric Assal
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Armand
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Switzerland
| | - Gilles Allali
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Alessandra Griffa
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute of Bioengineering, Center of Neuroprosthetics, Ecole Polytechnique Fédérale De Lausanne (EPFL), Geneva, Switzerland
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Groeger JL, Ayers E, Barzilai N, Beauchet O, Callisaya M, Torossian MR, Derby C, Doi T, Lipton RB, Milman S, Nakakubo S, Shimada H, Srikanth V, Wang C, Verghese J. Inflammatory biomarkers and motoric cognitive risk syndrome: Multicohort survey. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100151. [PMID: 36324399 PMCID: PMC9616385 DOI: 10.1016/j.cccb.2022.100151] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 12/05/2022]
Abstract
Raised IL-6 and CRP levels are associated with increased odds of MCR. IL-6 and CRP are involved in overlapping inflammatory, vascular, and neurological pathology. Establishing these pathways can guide interventions to prevent progression of MCR to dementia.
Background Inflammation may play a role in Motoric Cognitive Risk (MCR) syndrome, a pre-dementia syndrome comprised of slow gait and cognitive complaints. Our objective was to examine associations of inflammatory biomarkers with MCR. Methods We examined association of interleukin-6 (IL-6) and C-reactive protein (CRP) with prevalent MCR using logistic regression in 3,101 older adults (52% female) from five cohorts (National Center for Geriatrics & Gerontology Study of Geriatric Syndromes [NCGG-SGS], Central Control of Mobility in Aging [CCMA], Tasmanian Study of Cognition and Gait [TASCOG], LonGenity, and Einstein Aging Study [EAS]). Associations were reported as odds ratios adjusted for sex, age, education, depressive symptoms, body mass index, and vascular diseases (aOR) with 95% confidence intervals (CI). Meta-analysis and analyses stratified by vascular disease were also done. Results Although associations between higher (worse) CRP and IL-6 tertiles and MCR were only seen in three out of the five cohorts (EAS, TASCOG, and LonGenity), when a pooled meta-analysis was performed, a robust association was demonstrated. In meta-analysis, highest tertiles of IL-6 (aOR 1.57, 95%CI 1.01- 2.44) and CRP (aOR 1.65, 95%CI 1.09–2.48) was associated with MCR versus lowest tertiles in the pooled sample. Higher CRP was associated with MCR among those with vascular disease in TASCOG and LonGenity cohorts, and among those without vascular disease in EAS. Conclusions IL-6 and CRP levels are associated with MCR in older adults, and this association varies by presence of vascular disease.
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Affiliation(s)
- Justina L Groeger
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
- Corresponding author.
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Nir Barzilai
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States
- Institute for Aging Research, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Quebec, Canada; Centre of Research of "Institut Universitaire de Montreal", Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Michele Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, 2 Hastings Road, Frankston, Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
- The National Centre for Healthy Ageing, Melbourne, Victoria, Australia
| | - Maral R. Torossian
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Carol Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511, Japan
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Sofiya Milman
- Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States
- Institute for Aging Research, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi 474-8511, Japan
| | - Velandai Srikanth
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
- The National Centre for Healthy Ageing, Melbourne, Victoria, Australia
- Department of Geriatric Medicine, Peninsula Health, Peninsula Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
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Verghese J. Motoric cognitive risk syndrome: Next steps. Eur J Neurol 2021; 28:2467-2468. [PMID: 34057808 DOI: 10.1111/ene.14949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Joe Verghese
- Department of Neurology and Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
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