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motoric cognitive risk syndrome

Classification: - classified as a type of mild cognitive impairment given cognitive complaints without dementia with the added feature of slow gait Etiology: - risk factors - polypharmacy identified in patients with motoric cognitive risk syndrome [5] - depressive symptoms [12] - weak grip strength - sleeping disorder [12], daytime sleepiness [13] - hearing impairment - multiple falls [12] - lower level of education - hypertension [12] - diabetes mellitus (except China) - stroke [12] - heart disease - Parkinson's disease [12] - obesity - sedentary lifestyle [12] - psychiatric disorder [12] - personality risk factors* [6] - neuroticism (RR=1.3) - extroversion (RR=0.71) - conscientiousness* (RR=0.70) - openness (RR=0.77) - agreeableness (RR=0.83) * physical activity, depressive symptoms, & BMI partially accounted for personality trends [6] * industriousness is the facet of conscientiousness with the strongest association [7] Pathology: - a predementia syndrome - association with inflammation as assessed with serum C-reactive protein & serum IL-6 [8] - pre-clinical stage for Alzheimer's disease & vascular dementia. Clinical manifestations: - cognitive complaints - slow gait - risk factors difficult to distinguish from clinical manifestations (see Etiology above) Diagnostic criteria: - cognitive complaints - slow gait - older individuals without diagnosis of dementia or mobility disability Complications: - increased risk for Alzheimer's disease & vascular dementia [3] - risk for dementia stronger for motoric cognitive risk syndrome than either subjective memory complaint or slow gait speed alone [4] - increased risk for falls in the elderly - increased risk for movement disorder - increased risk for disability [3] - gait abnormalities predict disability, but not cognitive decline [9] - subjective memory concerns & motoric cognitive risk syndrome associated with automoble collisions & near-miss traffic incidents independent from objective cognitive impairment [11] Management: - addressing polypharmacy is a potentially modifiable risk factor [5] - a healthy diet & healthy lifestyle may reduce risk

General

mild cognitive impairment (MCI); benign senile forgetfulness; age-associated memory impairment (AAMI)

References

  1. Verghese J, Ayers E, Barzilai N et al Motoric cognitive risk syndrome. Neurology. 2014 Dec 9; 83(24): 2278-2284 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277675
  2. Marquez I, Garcia-Cifuentes E, Velandia FR et al Motoric Cognitive Risk Syndrome: Prevalence and Cognitive Performance. A cross-sectional study. Lancet Reg Health Am. 2021 Dec 27;8:100162 PMID: 36778728 PMCID: PMC9904094 Free PMC article https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(21)00158-7/fulltext
  3. Xiang K, Liu Y, Sun L Motoric Cognitive Risk Syndrome: Symptoms, Pathology, Diagnosis, and Recovery. Front Aging Neurosci. 2022 Feb 2;13:728799. PMID: 35185512 PMCID: PMC8847709 Free PMC article. Review.
  4. Semba RD, Tian Q, Carlson MC, Xue QL, Ferrucci L. Motoric cognitive risk syndrome: Integration of two early harbingers of dementia in older adults. Ageing Res Rev. 2020 Mar;58:101022. PMID: 31996326 PMCID: PMC7697173 Free PMC article. Review.
  5. George CJ, Verghese J. Motoric Cognitive Risk Syndrome in Polypharmacy. J Am Geriatr Soc. 2020 May;68(5):1072-1077. PMCID: PMC8083061 PMID: 32092166 Free PMC article.
  6. Stephan Y, Sutin AR, Canada B, Terracciano A. Personality and Motoric Cognitive Risk Syndrome. J Am Geriatr Soc. 2020 Apr;68(4):803-808. PMID: 31880326 PMCID: PMC7156302 Free PMC article.
  7. Stephan Y, Sutin AR, Luchetti M, Aschwanden D, Terracciano A. Facets of conscientiousness and motoric cognitive risk syndrome. J Psychiatr Res. 2022 Jul;151:73-77. PMID: 35468428 PMCID: PMC9843494 Free PMC article.
  8. Groeger JL, Ayers E, Barzilai N et al Inflammatory biomarkers and motoric cognitive risk syndrome: Multicohort survey. Cereb Circ Cogn Behav. 2022 Sep 13;3:100151. PMID: 36324399 PMCID: PMC9616385 Free PMC article.
  9. Ayers E, Verghese J. Gait Dysfunction in Motoric Cognitive Risk Syndrome. J Alzheimers Dis. 2019;71(s1):S95-S103. PMID: 30909242 PMCID: PMC7764990 Free PMC article.
  10. Verghese J, Wang C, Bennett DA, Lipton RB, Katz MJ, Ayers E. Motoric cognitive risk syndrome and predictors of transition to dementia: A multicenter study. Alzheimers Dement. 2019 Jul;15(7):870-877. PMID: 31164315 PMCID: PMC6646063 Free PMC article.
  11. Kurita S, Doi T, Harada K et al Motoric Cognitive Risk Syndrome and Traffic Incidents in Older Drivers in Japan. JAMA Netw Open. 2023;6(8):e2330475 PMID: 37624598 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2808754
  12. Jayakody O, Blumen HM, Breslin M, Wang C, Verghese J. Risk factors associated with the Motoric Cognitive Risk syndrome: A meta-analysis of data from a cross-national study. J Am Geriatr Soc. 2024 Sep;72(9):2656-2666. PMID: 38872608 PMCID: PMC11368625 (available on 2025-09-01) https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.19032
  13. Leroy V, Ayers E, Adhikari D, Verghese J. Association of Sleep Disturbances With Prevalent and Incident Motoric Cognitive Risk Syndrome in Community-Residing Older Adults. Neurology. 2024 Dec 10;103(11):e210054. PMID: 39504508 https://www.neurology.org/doi/10.1212/WNL.0000000000210054