Socioeconomic status as a risk factor for Motoric Cognitive Risk syndrome in a community-dwelling population: a longitudinal observational study

BACKGROUND: Motoric Cognitive Risk (MCR) is a syndrome characterised by measured slow gait speed and self-reported cognitive complaints. MCR is a high-risk state for adverse health outcomes in older adults, particularly cognitive impairment and dementia. Previous studies have identified risk factors for MCR, but the effect of socioeconomic status has, to date, been insufficiently examined. This study explores the association between MCR and socioeconomic status, as determined by occupational social class and years of education.

METHODS: 690 community-based adults of the Lothian Birth Cohort 1936 (LBC1936), aged 70 years at baseline, were followed up after six years and classified into non-MCR and MCR groups. We applied logistic regression analyses adjusting for demographic, lifestyle, and health covariates to investigate the association between MCR and years of education and occupational social class, categorised into manual vs non-manual occupations.

RESULTS: MCR prevalence at age 76 years was 5.6% (95%CI 4.0-7.6). After multivariate adjustment, participants of lower socioeconomic status (manual occupation) had a greater than threefold increased likelihood of MCR (adjusted odds ratio 3.55, 95%CI 1.46-8.74; p=0.005) compared to those of higher socioeconomic status (non-manual occupation).

CONCLUSION: Working in a manual job earlier in life triples the risk of MCR later in life, regardless of education. Unravelling this association will likely reveal important pathophysiological mechanisms underlying MCR and may unearth modifiable risk factors which could be targeted to reduce the incidence of MCR and, ultimately, dementia. Policy and healthcare practice addressing dementia risks such as MCR in their social context and early in the lifecourse could be effective strategies for reducing health inequalities in older age.