@article{047d1a11992845c18cd21ae01c28a3d7,
title = "Mechanisms of Motoric Cognitive Risk – hypotheses based on a systematic review and meta-analysis of longitudinal cohort studies of older adults",
abstract = "We aimed to refine the hypothesis that motoric cognitive risk (MCR), a syndrome combining measured slow gait speed and self-reported cognitive complaints, is prognostic of incident dementia and other major causes of morbidity in older age. We propose mechanisms on the relationship between motor and cognitive function and describe a roadmap to validate these hypotheses. We systematically searched major electronic databases from inception to August 2021 for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non-MCR group with any health outcome. Fifteen cohorts were combined by meta-analysis. Participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio [aHR] 1.76, 95% CI 1.49–2.08; I 2= 24.9%), dementia (aHR 2.12, 1.85–2.42; 33.1%), falls (adjusted Relative Risk 1.38, 1.15–1.66; 62.1%), and mortality (aHR 1.49, 1.16–1.91; 79.2%). The prognostic value of MCR is considerable and mechanisms underlying the syndrome are proposed.",
keywords = "dementia, falls, gait, mechanism, meta-analysis, mortality, motoric cognitive risk, pathophysiology, prevention, prognostic, review, subjective cognitive complaint",
author = "Mullin, {Donncha S.} and Alastair Cockburn and Miles Welstead and Michelle Luciano and Russ, {Tom C.} and Graciela Muniz-Terrera",
note = "Funding Information: Ruth Jenkins, academic support librarian at the University of Edinburgh, helped with search terms and recommending databases. Sue Lord, Lecturer at the Auckland University of Technology, New Zealand, supplied raw data from her study to allow for calculation of appropriate effect measure. Terry Quinn, Senior Clinical Lecturer, University of Glasgow, provided expert guidance on applying the GRADE criteria to prognostic studies. The present manuscript received no direct funding. All funded researchers are independent of their funders with payments to institution. Alastair Cockburn has no funding to declare. Donncha S. Mullin is undertaking a PhD Clinical Research Fellowship funded by a one‐off grant from the Masonic Charitable Foundation and the Royal College of Psychiatrists, United Kingdom. Miles Welstead is funded by an Age UK [MR/M01311/1] grant for PhD studentship. Michelle Luciano is funded by a Biotechnology and Biological Sciences Research Council (BBSRC) project grant and is a previous recipient of the Moray Award for travel from University of Edinburgh. Tom C. Russ is Principal Investigator 2021–2024 £1,518,000 grant; Chief Scientist Office: “NRS Neuroprogressive and Dementia Network” 2021–22 £216,666 grant; UKRI: “Sharing the diagnosis of dementia in the post‐Covid clinic: patient and practitioner perspectives” 2019‐21 £10,394 Catalytic grant; CSO: “Playlist for Life: Can personalized music be rapidly implemented in care homes as a non‐pharmacological intervention for dementia?” 2017–18 £56,519 grant; NERC‐MRC‐CSO: “Modelling historical air pollution and dementia/cognitive decline – towards a life course approach” 2016‐2021 £750,000 grant from Alzheimer Scotland for Phase 2 of the Alzheimer Scotland Dementia Research Centre; Co‐investigator 2019‐2021 £733,246 Research grant; MRC: “Brain imaging and cognitive ageing in the Lothian Birth Cohort 1936: IV” 2017‐18 $40,000 from the Japan Agency for Medical Research and Development/New York Academy of Sciences Interstellar Initiative. Tom C. Russ occasionally completes medicolegal reports for Solicitors in Edinburgh. These payments are made to him but relate solely to his clinical work and not the academic work under review. Tom C. Russ receives NHS study leave expenses (travel, accommodation, and registration). Graciela Muniz‐Terrera is funded by the Medical Research Council methodology board and received consulting fees for an NIH‐funded grant. Publisher Copyright: {\textcopyright} 2021 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association",
year = "2022",
month = feb,
day = "9",
doi = "10.1101/2021.10.26.21265519",
language = "English",
volume = "18",
pages = "2413--2427",
journal = "Alzheimer's & Dementia: The Journal of the Alzheimer's Association",
issn = "1552-5260",
publisher = "Wiley",
number = "12",
}