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Cotton K, Ayers E, Jin Y, Beauchet O, Derby CA, Lipton RB, Katz M, Galery K, Gaudreau P, Verghese J. Elevated Blood Homocysteine Increases the Risk of Incident Motoric Cognitive Risk Syndrome: A Two-Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae114. [PMID: 38671552 PMCID: PMC11157967 DOI: 10.1093/gerona/glae114] [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: 01/22/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Motoric Cognitive Risk (MCR) syndrome, a predementia syndrome characterized by cognitive complaints and slow gait, may have an underlying vascular etiology. Elevated blood levels of homocysteine, a known vascular risk factor, have been linked to physical and cognitive decline in older adults, though the relationship with MCR is unknown. We aimed to identify the association between homocysteine and MCR risk. METHODS We examined the association between baseline homocysteine levels and incident MCR using Cox proportional hazard models in 1826 community-dwelling older adults (55% women) from 2 cohorts (Einstein Aging Study [EAS] and Quebec Longitudinal Study on Nutrition and Successful Aging [NuAge]). We calculated hazard ratios (HR) with 95% confidence intervals (CI), for each cohort as well as stratified by sex and vascular disease/risk factors. RESULTS Median follow-up time was 2.2 years in EAS and 3.0 years in NuAge. Individuals with elevated baseline homocysteine levels (>14 µmol/L) had a significantly higher risk of incident MCR compared to those with normal levels in NuAge (HR 1.41, 95% CI: 1.01-1.97, p = .04), after adjusting for covariates. Our exploratory stratified analyses found that these associations were significant only in men with vascular disease/risk factors. CONCLUSIONS Higher blood homocysteine levels are associated with an increased risk of developing MCR in older adults, particularly in men with vascular disease or vascular risk factors.
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Affiliation(s)
- Kelly Cotton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Emmeline Ayers
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Ying Jin
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Olivier Beauchet
- Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Carol A Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mindy Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kevin Galery
- Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada
| | - Pierrette Gaudreau
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Centre Hospitalier de l’Université de Montréal Research Center, Montreal, Quebec, Canada
| | - Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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Perlaki G, Darnai G, Arató Á, Alhour HA, Szente A, Áfra E, Nagy SA, Horváth R, Kovács N, Dóczi T, Orsi G, Janszky J. Gray Matter Changes Following Mild COVID-19: An MR Morphometric Study in Healthy Young People. J Magn Reson Imaging 2024; 59:2152-2161. [PMID: 37602529 DOI: 10.1002/jmri.28970] [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: 02/22/2023] [Revised: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Although COVID-19 is primarily an acute respiratory infection, 5%-40% of patients develop late and prolonged symptoms with frequent neurological complaints, known as long COVID syndrome. The presentation of the disease suggests that COVID infection may cause functional and/or morphological central nervous system alterations, but studies published in the literature report contradictory findings. PURPOSE To investigate the chronic effects of COVID-19 on cerebral grey matter in a group of young patients without comorbidities, with mild course of COVID infection and no medical complaints at the time of examination. STUDY TYPE Prospective. POPULATION Thirty-eight young (age = 26.6 ± 5.0 years; male/female = 14/24), adult participants who recovered from mild COVID infection without a history of clinical long COVID and 37 healthy control subjects (age = 25.9 ± 2.8 years; male/female = 14/23). FIELD STRENGTH/SEQUENCE Three Tesla, 3D T1-weighted magnetization-prepared rapid gradient-echo, 2D T2-weighted turbo spin-echo. ASSESSMENT MRI-based morphometry and volumetry along with neuropsychological testing and self-assessed questionnaire. STATISTICAL TESTS Fisher's exact test, Mann-Whitney U-test, and multiple linear regression analyses were used to assess differences between COVID and healthy control groups. P < 0.05 was used as cutoff for significance. RESULTS In the COVID group, significantly lower bilateral mean cortical thickness (left/right-hemisphere: 2.51 ± 0.06 mm vs. 2.56 ± 0.07 mm, η2 p = 0.102/2.50 ± 0.06 mm vs. 2.54 ± 0.07 mm, η2 p = 0.101), lower subcortical gray matter (57881 ± 3998 mm3 vs. 60470 ± 5211 mm3, η2 p = 0.100) and lower right olfactory bulb volume (52.28 ± 13.55 mm3 vs. 60.98 ± 15.8 mm3, η2 p = 0.078) were found. In patients with moderate to severe anosmia, cortical thickness was significantly lower bilaterally, as compared to patients without olfactory function loss (left/right-hemisphere: 2.50 ± 0.06 mm vs. 2.56 ± 0.05 mm, η2 = 0.173/2.49 ± 0.06 mm vs. 2.55 ± 0.05 mm, η2 = 0.189). Using further exploratory analysis, significantly reduced cortical thickness was detected locally in the right lateral orbitofrontal cortex in the COVID group (2.53 ± 0.10 mm vs. 2.60 ± 0.09 mm, η2 p = 0.112). DATA CONCLUSION Even without any subjective or objective neurological complaints at the time of the MR scan, subjects in the COVID group showed gray matter alterations in cortical thickness and subcortical gray matter volume. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Gábor Perlaki
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- ELKH-PTE Clinical Neuroscience MR Research Group, Eötvös Loránd Research Network, Pécs, Hungary
- Pécs Diagnostic Centre, NeuroCT Ltd., Pécs, Hungary
| | - Gergely Darnai
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- ELKH-PTE Clinical Neuroscience MR Research Group, Eötvös Loránd Research Network, Pécs, Hungary
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Ákos Arató
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | | | - Anna Szente
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Eszter Áfra
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Szilvia Anett Nagy
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- ELKH-PTE Clinical Neuroscience MR Research Group, Eötvös Loránd Research Network, Pécs, Hungary
- Pécs Diagnostic Centre, NeuroCT Ltd., Pécs, Hungary
- Structural Neurobiology Research Group, Szentágothai Research Centre, University of Pecs, Pécs, Hungary
| | - Réka Horváth
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Norbert Kovács
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Dóczi
- Pécs Diagnostic Centre, NeuroCT Ltd., Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - Gergely Orsi
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- ELKH-PTE Clinical Neuroscience MR Research Group, Eötvös Loránd Research Network, Pécs, Hungary
- Pécs Diagnostic Centre, NeuroCT Ltd., Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - József Janszky
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
- ELKH-PTE Clinical Neuroscience MR Research Group, Eötvös Loránd Research Network, Pécs, Hungary
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Xie H, Zhang N, Xia C, Ding Y, Zhao H, Huang Y. The clinical characteristics of cerebral small vessel disease patients with motoric cognitive risk syndrome during single- and dual-task walking. Heliyon 2024; 10:e30007. [PMID: 38742083 PMCID: PMC11089308 DOI: 10.1016/j.heliyon.2024.e30007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/10/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024] Open
Abstract
Objective We aimed to (1) identify neuroimaging biomarkers of distinguishing motoric cognitive risk syndrome (MCRS) risk among older Chinese adults with cerebral small vessel disease (CSVD) and (2) detect differences in gait parameters and neuroimaging biomarkers between CSVD individual with and without MCRS, especially during dual-task walking (DTW). Methods We enrolled 126 inpatients with CSVD who were divided into two groups according to MCRS status. Data on basic parameters, variability, asymmetry, and coordination were collected during single-task walking (STW) and DTW. Neuroimaging features (white matter hyperintensities, lacunes, and microbleeds) and total disease burden were calculated. Analysis of variance and logistic regression analyses were applied to assess the role of STW, DTW, and neuroimaging biomarkers in MCRS. Results In total, 126 consecutive inpatients with CSVD were included (84 and 42 patients were classified as MCRS-negative and MCRS-positive, respectively). The MCRS-positive group showed poorer performance for nearly all gait parameters compared with the MCRS-negative group during cognitive DTW. Meanwhile, all gait parameters except asymmetry were assessed in participants with MCRS for significant deterioration during cognitive DTW compared with that during STW. However, only basic parameters differed between STW and cognitive DTW in participants without MCRS. A significant independent association between total CSVD scores and MCRS was also detected. Conclusions For CSVD patients, with higher total CSVD burden rather than any single neuroimaging marker, was linked to a greater risk of MCRS. In addition, CSVD individuals with MCRS had higher variability and phase coordination index (PCI), especially in cognitive DTW. Thus, they should concentrate more on their gait variability or coordination and reduce secondary task loads while walking in daily life, especially in cognitive secondary tasks.
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Affiliation(s)
- Hongyang Xie
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Nan Zhang
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Cuiqiao Xia
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Yu Ding
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Hongyi Zhao
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
- Department of Neurology, Number 984 Hospital of the PLA, Beijing, China
| | - Yonghua Huang
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
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Fukatsu-Chikumoto A, Hirano T, Takahashi S, Ishida T, Yasuda K, Donishi T, Suga K, Doi K, Oishi K, Ohata S, Murata Y, Yamaji Y, Asami-Noyama M, Edakuni N, Kakugawa T, Matsunaga K. Correlation between frailty and reduction in cortical thickness in patients with chronic obstructive pulmonary disease. Sci Rep 2024; 14:6106. [PMID: 38480723 PMCID: PMC10937661 DOI: 10.1038/s41598-024-53933-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 02/06/2024] [Indexed: 03/17/2024] Open
Abstract
Physical inactivity and cognitive impairment in patients with chronic obstructive pulmonary disease (COPD) can lead to frailty and poor prognoses. However, little is known regarding the association between frailty and the human brain. We hypothesized that the brain structure could change according to frailty in patients with COPD and focused on cortical thickness. Cortical thickness measured by magnetic resonance imaging and frailty scores using the Kihon Checklist (KCL) were assessed in 40 patients with stable COPD and 20 healthy controls. Among the 34 regions assessed, multiple regions were thinner in patients with COPD than in healthy individuals (p < 0.05). We found significant negative correlations between the eight regions and the KCL scores only in patients with COPD. After adjusting for age and cognitive impairment, the association between the left and six right regions remained statistically significant. The correlation coefficient was the strongest in the bilateral superior frontal gyrus (left: ρ = - 0.5319, p = 0.0006) (right: ρ = - 0.5361, p = 0.0005). Interestingly, among the KCL scores, the daily activity domain showed the strongest correlation (sensitivity, 90%; specificity, 73%) with the bottom quartile of the reduction in the superior frontal gyrus. Frailty in patients with COPD is associated with a thickness reduction in the cortical regions, reflecting social vulnerability.
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Affiliation(s)
- Ayumi Fukatsu-Chikumoto
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan.
| | - Shun Takahashi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, 641-0012, Japan
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, 583-8555, Japan
- Clinical Research and Education Center, Asakayama General Hospital, Sakai, 590-0018, Japan
| | - Takuya Ishida
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, 641-0012, Japan
| | - Kasumi Yasuda
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, 641-0012, Japan
| | - Tomohiro Donishi
- Department of System Neurophysiology, Wakayama Medical University, Wakayama, 641-0012, Japan
| | - Kazuyoshi Suga
- Department of Radiology, St. Hill Hospital, Ube, 755-0155, Japan
| | - Keiko Doi
- Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, Ube, 755-8505, Japan
| | - Keiji Oishi
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Shuichiro Ohata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Yoriyuki Murata
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Maki Asami-Noyama
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Nobutaka Edakuni
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
| | - Tomoyuki Kakugawa
- Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, Ube, 755-8505, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-Kogushi, Ube, 755-8505, Japan
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Xu W, Bai A, Liang Y, Lin Z. Motoric Cognitive Risk Syndrome and the Risk of Incident Dementia: A Systematic Review and Meta-Analysis of Cohort Studies. Gerontology 2024; 70:479-490. [PMID: 38461816 PMCID: PMC11098020 DOI: 10.1159/000535082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/03/2023] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Epidemiologic studies have indicated an association of motoric cognitive risk syndrome (MCR), a pre-dementia stage characterized by the presence of cognitive complaints and a slow gait, with increased risk of incident dementia. OBJECTIVES We aimed to clarify this association using meta-analysis. METHODS We systematically searched the PubMed, Embase, and Web of Science databases up to December 2022 for relevant studies that investigated the association between MCR and incident all-cause dementia and Alzheimer's disease (AD). The random-effects model was used to determine a pooled-effect estimate of the association. RESULTS We identified seven articles that corresponded with nine cohort studies investigating the association between MCR and the risk of dementia. Pooled analysis showed that MCR was associated with a significantly increased risk of incident all-cause dementia (HR = 2.28; 95% CI: 1.90-2.73) and AD (HR = 2.05; 95% CI: 1.61-2.61). Sensitivity analysis showed that there was no evidence that individual studies influenced the pooled-effect estimate, verifying the robustness of the results. CONCLUSIONS Our results confirm that MCR is an independent risk factor of incident all-cause dementia and AD. Future studies are needed to better understand the mechanisms underlying this association.
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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, Southern Medical University, Guangzhou, China
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 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, Southern Medical University, Guangzhou, China
| | - Zhanyi Lin
- Department of Cardiology, Guangdong Provincial Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
- Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
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Byun S, Lee HJ, Kim JS, Choi E, Lee S, Kim TH, Kim JH, Han JW, Kim KW. Exploring shared neural substrates underlying cognition and gait variability in adults without dementia. Alzheimers Res Ther 2023; 15:206. [PMID: 38012628 PMCID: PMC10680297 DOI: 10.1186/s13195-023-01354-y] [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: 02/22/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND High gait variability is associated with neurodegeneration and cognitive impairments and is predictive of cognitive impairment and dementia. The objective of this study was to identify cortical or subcortical structures of the brain shared by gait variability measured using a body-worn tri-axial accelerometer (TAA) and cognitive function. METHODS This study is a part of a larger population-based cohort study on cognitive aging and dementia. The study included 207 participants without dementia, with a mean age of 72.6, and 45.4% of them are females. We conducted standardized diagnostic interview including a detailed medical history, physical and neurological examinations, and laboratory tests for cognitive impairment. We obtained gait variability during walking using a body-worn TAA along and measured cortical thickness and subcortical volume from brain magnetic resonance (MR) images. We cross-sectionally investigated the cortical and subcortical neural structures associated with gait variability and the shared neural substrates of gait variability and cognitive function. RESULTS Higher gait variability was associated with the lower cognitive function and thinner cortical gray matter but not smaller subcortical structures. Among the clusters exhibiting correlations with gait variability, one that included the inferior temporal, entorhinal, parahippocampal, fusiform, and lingual regions in the left hemisphere was also associated with global cognitive and verbal memory function. Mediation analysis results revealed that the cluster's cortical thickness played a mediating role in the association between gait variability and cognitive function. CONCLUSION Gait variability and cognitive function may share neural substrates, specifically in regions related to memory and visuospatial navigation.
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Affiliation(s)
- Seonjeong Byun
- Department of Neuropsychiatry, College of Medicine, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyang Jun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea
| | - Jun Sung Kim
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Euna Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Subin Lee
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea.
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Beauchet O, Matskiv J, Gaudreau P, Allali G. New onset, transient and stable motoric cognitive risk syndrome: Clinical characteristics and association with incidence of probable dementia in the NuAge cohort. Front Aging Neurosci 2023; 14:1063702. [PMID: 36742207 PMCID: PMC9893109 DOI: 10.3389/fnagi.2022.1063702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/30/2022] [Indexed: 01/21/2023] Open
Abstract
BackgroundMotoric cognitive risk syndrome (MCR) is a pre-dementia stage. The existence of stable and transient MCR, their related clinical characteristics and their association with incident dementia is a matter of debate.ObjectiveThis study aims to examine the clinical characteristics and the time course associated with new onset, transient and stable MCR, and their association with incidence of probable dementia in community-dwelling older adults living in the province of Quebec (Canada).DesignQuebec elderly population-based observational cohort study with 3 years of follow-up.SettingCommunity dwellers.SubjectsA subset of participants (n = 1,113) from the “Quebec Longitudinal Study on Nutrition and Successful Aging” (NuAge) cohort.MethodsParticipants with MCR were identified at baseline and after 1 year of follow-up. Socio-demographic characteristics, 30-item Geriatric depression scale (GDS) score, cardiovascular risk factors and diseases were recorded at baseline. Incidence of probable dementia was measured at annual follow-up visits over a 3-year period.ResultsOver the period of the first year of follow-up, the prevalence of MCR was 8.5% with 4.3% having new onset MCR, 2.8% transient MCR and 1.4% stable MCR. A higher 30-item GDS score was reported with new onset and transient MCR, and the highest prevalence of cerebrovascular diseases was shown with stable MCR compared to non-MCR participants (p < 0.05). MCR was associated with overall incidence of probable dementia, regardless of its status (Hazard Ratio ≥ 1.86, p ≤ 0.034).ConclusionGreater prevalence of depressive symptoms and cerebrovascular diseases were reported, respectively, with new onset and transient MCR, and stable MCR. The association of MCR with incidence of probable dementia remains significant, regardless of MCR subtypes.
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Affiliation(s)
- Olivier Beauchet
- Departments of Medicine and Geriatrics, University of Montreal, Montreal, QC, Canada
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - Jacqueline Matskiv
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
| | - Pierrette Gaudreau
- Departments of Medicine and Geriatrics, University of Montreal, Montreal, QC, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Gilles Allali
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Blumen HM, Jayakody O, Verghese J. Gait in cerebral small vessel disease, pre-dementia, and dementia: A systematic review. Int J Stroke 2023; 18:53-61. [PMID: 35797006 PMCID: PMC9841467 DOI: 10.1177/17474930221114562] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The interrelationships between gait, cerebral small vessel disease (CSVD), and cognitive impairments in aging are not well-understood-despite their common co-occurrence. OBJECTIVE To systematically review studies of gait impairment in CSVD, pre-dementia, and dementia, and to identify key gaps for future research and novel pathways toward intervention. METHODS A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided search strategy was implemented in PubMed to identify relevant studies. Potential articles (n = 263) published prior to 1 December 2021 were screened by two reviewers. Studies with sample sizes >20 and including some adults over > 65 years (n = 202) were included. RESULTS The key findings were that (1) adverse gait and cognitive outcomes were associated with several (rather than select) CSVD pathologies distributed across the brain, and (2) poor gait and CSVD pathologies were more strongly associated with dementia with a vascular, rather than an Alzheimer's disease-related, cause. DISCUSSION A better understanding of the interrelationships between gait performance in CSVD, pre-dementia, and dementia requires studies examining (1) comprehensive patterns in the clinical manifestations of CSVD, (2) racially/ethnically diverse samples, (3) samples followed for extended periods of time or across the adult life span, (4) non-traditional CSVD neuroimaging markers (e.g. resting-state functional magnetic resonance imaging (fMRI)), and (5) continuous (e.g. wearable sensors) and complex (e.g. dual-task) walking performance.
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Affiliation(s)
- Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Oshadi Jayakody
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
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Lamichhane B, Luckett PH, Dierker D, Yun Park K, Burton H, Olufawo M, Trevino G, Lee JJ, Daniel AGS, Hacker CD, Marcus DS, Shimony JS, Leuthardt EC. Structural gray matter alterations in glioblastoma and high-grade glioma-A potential biomarker of survival. Neurooncol Adv 2023; 5:vdad034. [PMID: 37152811 PMCID: PMC10162111 DOI: 10.1093/noajnl/vdad034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Background Patients with glioblastoma (GBM) and high-grade glioma (HGG, World Health Organization [WHO] grade IV glioma) have a poor prognosis. Consequently, there is an unmet clinical need for accessible and noninvasively acquired predictive biomarkers of overall survival in patients. This study evaluated morphological changes in the brain separated from the tumor invasion site (ie, contralateral hemisphere). Specifically, we examined the prognostic value of widespread alterations of cortical thickness (CT) in GBM/HGG patients. Methods We used FreeSurfer, applied with high-resolution T1-weighted MRI, to examine CT, evaluated prior to standard treatment with surgery and chemoradiation in patients (GBM/HGG, N = 162, mean age 61.3 years) and 127 healthy controls (HC; 61.9 years mean age). We then compared CT in patients to HC and studied patients' associated changes in CT as a potential biomarker of overall survival. Results Compared to HC cases, patients had thinner gray matter in the contralesional hemisphere at the time of tumor diagnosis. patients had significant cortical thinning in parietal, temporal, and occipital lobes. Fourteen cortical parcels showed reduced CT, whereas in 5, it was thicker in patients' cases. Notably, CT in the contralesional hemisphere, various lobes, and parcels was predictive of overall survival. A machine learning classification algorithm showed that CT could differentiate short- and long-term survival patients with an accuracy of 83.3%. Conclusions These findings identify previously unnoticed structural changes in the cortex located in the hemisphere contralateral to the primary tumor mass. Observed changes in CT may have prognostic value, which could influence care and treatment planning for individual patients.
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Affiliation(s)
- Bidhan Lamichhane
- Corresponding Author: Bidhan Lamichhane, PhD, Department of Neurosurgery, Washington University School of Medicine, Box 8057, 660 South Euclid, St. Louis, MO 63110, USA ()
| | - Patrick H Luckett
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Donna Dierker
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ki Yun Park
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Harold Burton
- Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael Olufawo
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Gabriel Trevino
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John J Lee
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andy G S Daniel
- Department of Biomedical Engineering, Washington University in Saint Louis, St. Louis, Missouri, USA
| | - Carl D Hacker
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Daniel S Marcus
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Eric C Leuthardt
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neuroscience, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Biomedical Engineering, Washington University in Saint Louis, St. Louis, Missouri, USA
- Department of Mechanical Engineering and Materials Science, Washington University, St. Louis, Missouri, USA
- Center for Innovation in Neuroscience and Technology, Washington University School of Medicine, St. Louis, Missouri, USA
- Brain Laser Center, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Neurotechnology, Washington University School of Medicine, St. Louis, Missouri, USA
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10
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Lu J, Huang R, Peng Y, Zhang J, Liang K, Wang Y, Feng Y, Wang Z. Mendelian Randomization Analyses Accounting for Causal Effect of COVID-19 on Brain Imaging-Derived Phenotypes. J Alzheimers Dis 2023; 96:1059-1070. [PMID: 37955088 DOI: 10.3233/jad-230626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has been a major challenge to global health and a financial burden. Little is known regarding the possible causal effects of COVID-19 on the macro- and micro-structures of the human brain. OBJECTIVE To determine the causal links between susceptibility, hospitalization, and the severity of COVID-19 and brain imaging-derived phenotypes (IDPs). METHODS Mendelian randomization (MR) analyses were performed to investigate the causal effect of three COVID-19 exposures (SARS-CoV-2 infection, hospitalized COVID-19, and critical COVID-19) on brain structure employing summary datasets of genome-wide association studies. RESULTS In terms of cortical phenotypes, hospitalization due to COVID-19 was associated with a global decrease in the surface area (SA) of the cortex structure (β= -624.77, 95% CI: -1227.88 to -21.66, p = 0.042). At the regional level, SARS-CoV-2 infection was found to have a nominally causal effect on the thickness (TH) of the postcentral region (β= -0.004, 95% CI: -0.007 to -0.001, p = 0.01), as well as eight other IDPs. Hospitalized COVID-19 has a nominally causal relationship with TH of postcentral (β= -0.004, 95% CI: -0.007 to -0.001, p = 0.01) and other 6 IDPs. The nominally causal effects of critical COVID-19 on TH of medial orbitofrontal (β=0.004, 95% CI: 0.001to 0.007, p = 0.004) and other 7 IDPs were revealed. CONCLUSIONS Our study provides compelling genetic evidence supporting causal relationships between three COVID-19 traits and brain IDPs. This discovery holds promise for enhancing predictions and interventions in brain imaging.
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Affiliation(s)
- Jiajie Lu
- Institute of Neuroscience, Department of Neurosurgery, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Rihong Huang
- Institute of Neuroscience, Department of Neurosurgery, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Yuecheng Peng
- Institute of Neuroscience, Department of Neurosurgery, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Jinming Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kairong Liang
- Institute of Neuroscience, Department of Neurosurgery, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yezhong Wang
- Institute of Neuroscience, Department of Neurosurgery, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yi Feng
- Department of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Health, Guangzhou, China
| | - Zhaotao Wang
- Institute of Neuroscience, Department of Neurosurgery, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
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11
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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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12
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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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13
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Felix N, Ayers E, Verghese J, Blumen HM. Increased Social Support Reduces the Incidence of Motoric Cognitive Risk Syndrome. Innov Aging 2022; 6:igac048. [PMID: 36081405 PMCID: PMC9447853 DOI: 10.1093/geroni/igac048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Objectives
The motoric cognitive risk syndrome (MCR) is a predementia syndrome characterized by slow gait and cognitive complaint. The relationship between MCR and social support—a potentially modifiable risk factor of dementia—is currently unknown. The current study aimed to determine whether MCR incidence varies as a function of social support in aging.
Research Design and Methods
We examined MCR incidence in 506 community-dwelling older adults (M Age 76.59; 57.3% female) without MCR or dementia at baseline. We quantified perceived levels of social support with the Medical Outcomes Study Social Support Survey, incorporating four different categories of support: (a) emotional/informational support, (b) tangible support, (c) affectionate support, and (d) positive social interactions. We used Cox regression analyses, adjusted for age, sex, race/ethnicity, education, marital status, comorbidities, and global cognition, to estimate hazard ratios (aHR) with 95% confidence intervals (CIs).
Results
Over a median follow-up time of 2.5 years (range = 1–7 years), 38 participants (9.8%) developed MCR. Increased tangible support decreased the risk of MCR by 30% (aHR: 0.70, 95% CI: 0.53–0.92, p = .011). Increased overall social support decreased the risk of MCR by 33% (aHR: 0.67, 95% CI: 0.46–0.98, p = .038). Other subcategories of social support were not associated with a decreased risk of MCR (p > .05).
Discussion and Implications
Higher levels of tangible social support, as well as overall social support, were associated with reduced risk for MCR in older adults. Increasing social support may be a promising avenue of intervention for reducing the risk of MCR, dementia, and other forms of cognitive decline.
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Affiliation(s)
- Nicole Felix
- Department of Medicine, Albert Einstein College of Medicine , Bronx, New York , USA
| | - Emmeline Ayers
- Departments of Neurology, Albert Einstein College of Medicine , Bronx, New York , USA
| | - Joe Verghese
- Department of Medicine, Albert Einstein College of Medicine , Bronx, New York , USA
- Departments of Neurology, Albert Einstein College of Medicine , Bronx, New York , USA
| | - Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine , Bronx, New York , USA
- Departments of Neurology, Albert Einstein College of Medicine , Bronx, New York , USA
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14
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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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Marquez I, Garcia-Cifuentes E, Velandia FR, Iragorri A, Saavedra AM, Borda MG, Osuna M, Ailshire J, Cano-Gutierrez CA. Motoric Cognitive Risk Syndrome: Prevalence and Cognitive Performance. A cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2022; 8:100162. [PMID: 36778728 PMCID: PMC9904094 DOI: 10.1016/j.lana.2021.100162] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
BACKGROUND Motoric Cognitive Risk Syndrome (MCR) is a predementia stage where slow gait speed and subjective memory complaints are present. The purpose of this study was to estimate the prevalence of MCR and assess its relationship with sociodemographic factors and chronic conditions. METHODS This is a secondary analysis of the SABE Colombia study conducted in 2015. The analytic sample consisted of 17·577 participants. After determining MCR prevalence, logistic regression was performed to examine the correlates of MCR. FINDINGS The prevalence of MCR was 10·71 %. The median age was 71 years and women composed 74·63 % of the MCR group. After adjusting for confounding variables MCR was associated with increasing age (OR 1·69, CI 1·43 - 1·92), no or low education (OR 1·99, CI 1·67- 2·37), MMSE (OR 0·93, CI 0·91 - 0·95) and chronic conditions such as mental disorders (OR 1·36, CI 1·11-1·67), history of myocardial infarction (OR 1·24, CI 1·04 - 1·47), hypertension (OR 1·23, CI 1·08 - 1·40) and diabetes (OR 1.18, CI 1.01 - 1.37). INTERPRETATION This study found a prevalence of 10·71 % of MCR in Colombian older adults. Additionally, MCR was associated with chronic conditions and sociodemographic factors identified in prior studies. These results increase the awareness of a novel predementia stage whose identification can be performed by clinicians in the outpatient clinic, minimizing the cost of a full neuropsychologic evaluation performed in a memory clinic. FUNDING Funded by the Administrative Department of Science, Technology and Innovation (Colciencias) and the Ministry of Health and Social Protection of Colombia.
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Affiliation(s)
- Isabel Marquez
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Elkin Garcia-Cifuentes
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
- Corresponding author: Elkin García-Cifuentes, Unidad de Neurología, Hospital Universitario San Ignacio, Carrera 7 No. 40–62 Bogotá 110231 (Colombia)
| | - Felipe Ramirez Velandia
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Angela Iragorri
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Ana Maria Saavedra
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Miguel Germán Borda
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Margarita Osuna
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA
| | - Jennifer Ailshire
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA
| | - Carlos Alberto Cano-Gutierrez
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia
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16
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Gomez GT, Gottesman RF, Gabriel KP, Palta P, Gross AL, Soldan A, Albert MS, Sullivan KJ, Jack CR, Knopman DS, Windham BG, Walker KA. The association of motoric cognitive risk with incident dementia and neuroimaging characteristics: The Atherosclerosis Risk in Communities Study. Alzheimers Dement 2022; 18:434-444. [PMID: 34786837 PMCID: PMC10064850 DOI: 10.1002/alz.12412] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/05/2021] [Accepted: 06/01/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Motoric cognitive risk (MCR), a clinical syndrome characterized by slow gait speed and subjective cognitive complaints, has been associated with dementia risk. The neuropathological features underlying MCR remain poorly understood. METHODS The Atherosclerosis Risk in Communities (ARIC) community-based cohort study classified participants using standardized criteria as MCR+/- and mild cognitive impairment (MCI)+/- at study baseline (2011-2013). We examined the 5-year dementia risk and baseline brain structural/molecular abnormalities associated with MCR+ and MCI+ status. RESULTS Of 5023 nondemented participants included, 204 were MCR+ and 1030 were MCI+. Both MCR+ and MCI+ participants demonstrated increased dementia risk. The pattern of structural brain abnormalities associated with MCR+ differed from that of MCI+. Whereas MCI+ was associated with comparatively smaller volumes in brain regions vulnerable to Alzheimer's disease pathology, MCR+ status was associated with smaller volumes in frontoparietal regions and greater white matter abnormalities. DISCUSSION MCR may represent a predementia syndrome characterized by prominent white matter abnormalities and frontoparietal atrophy.
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Affiliation(s)
- Gabriela T. Gomez
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rebecca F. Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Priya Palta
- Department of Medicine, Columbia University Medical Center, New York, NY
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kevin J. Sullivan
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS
| | | | | | - B. Gwen Windham
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS
| | - Keenan A. Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD
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