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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; I2 = 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. [ABSTRACT FROM AUTHOR]

Background: Air pollution has been associated with the risk of pathological cognitive decline and dementia (Chandra et al., 2022). Past research has focused on cross‐sectional associations or short‐term exposure measurement, and there is a lack of studies investigating the impact of air pollution throughout the life course of the individual which examines sensitive periods. In this study, the relationship of air pollution exposure at different periods across the life course and the risk of dementia and mild cognitive impairment (MCI) was investigated. Method: Historic fine particulate matter (PM2.5) was modeled using the EMEP4UK atmospheric chemistry transport model for several time periods (1935, 1950, 1970, 1980, and 1990) was combined with contemporary data for time period 2001 and 2007 to calculate the lifetime exposure for 576 participants of the Lothian Birth Cohort (LBC) 1936 who had information about lifetime residential history. There were 69 individuals with all‐cause dementia from age 70 years (baseline) onwards were clinically ascertained and 156 individuals with MCI derived at the ages 76, 79, and 82 years according to the NIA‐AA workgroups guidelines. A multivariable Cox proportional hazards model was developed to investigate associations between PM2.5 exposure at each time period with both cognitive outcomes, adjusting for sex, parental occupational social class (OSC) and of Apolipoprotein e4 allele (APOE4) status, childhood smoking (<16 years), years of education, adulthood OSC, smoking status at age 70, and early retirement (<60 years) dependent on time period. Result: Higher exposure (1SD [0.25µg/m3]) of PM2.5 in later life (2007, age 71 years) had a statistically significant (P = 0.0262) association with increased risk of MCI (HR 1.25, 95% CI 1.02‐1.54) and other time periods were positively associated but not statistically significant (P>0.05). There was no statistically significant (P>0.05) association between PM2.5 exposure at any time period and risk of all cause dementia. Conclusion: Later life exposure to PM2.5 had a positive association with MCI which could suggest that this is a sensitive period in the life course model. This could indicate that people in later life are more susceptible to the impact of air pollution on cognitive decline and therefore risk of MCI. [ABSTRACT FROM AUTHOR]

Background: Motoric cognitive risk syndrome (MCR) ‐ objective slow gait and subjective cognitive complaints ‐ is quick and easy to measure, making it a potentially useful clinical tool for identifying those at high risk of developing dementia. This is the first exploration of MCR syndrome's predictive ability for incident dementia in a Scottish cohort (Lothian Birth Cohort 1936) and the first examination of the various trajectories of MCR. Method: We classified a total of 680 community‐dwelling participants (mean [SD] age 76.3 [0.8] years) free from dementia into non‐MCR or MCR groups. We used cox proportional hazard methods to evaluate the risk of developing all‐cause dementia in the years following MCR diagnosis. Our final model adjusted for age, sex, comorbidity index, apolipoprotein E status, physical activity level, and years of education. We analysed the trajectories for everyone with MCR by tracking their outcomes over 9 years. All analyses were performed in R version 4.0.2. Result: The prevalence of MCR at baseline was 5.6% (n = 38/680). After 9 years of follow‐up, 11.6% (n = 79/680) of the total cohort developed dementia. The presence of MCR increased the risk of dementia (adjusted hazard ratio 2.37 [95%CI 1.06‐5.32; p = 0.0359]). The trajectories of those with MCR at baseline were: i) reverted to healthy (n = 6/38), ii) ongoing MCR (n = 13/38), iii) progressed to dementia (n = 9/38), or iv) died (n = 10/38). 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. Individuals with MCR follow similar trajectories to the related predementia syndrome, Mild Cognitive Impairment. [ABSTRACT FROM AUTHOR]

Background: Motoric Cognitive Risk (MCR), a syndrome combining objective slow gait speed and subjective cognitive complaints, is being used to identify older adults at high risk of developing dementia. Yet, uncertainty exists regarding the prognostic value of MCR for this and other major causes of morbidity in ageing, such as cognitive impairment and falls. This review is the first to synthesise all mental and physical health outcomes associated with MCR since the term was coined in 2013, and with its component parts of objective slow gait and subjective cognitive complaint prior to 2013. The aim of the review is to evaluate the prognostic value of MCR for adverse age‐related health outcomes. Method: Results from multiple databases (MEDLINE, AMED, EMBASE, CINAHL, PsycINFO, and the Cochrane library; inception to May 2021) for original longitudinal cohort studies of adults aged ≥60 years that compared an MCR group to a non‐MCR group, for any health outcome were screened independently and risk of bias was assessed. We meta‐analysed incident health outcome results where appropriate using a restricted maximum‐likelihood estimator. Result: Of 1057 records identified, 15 studies were eligible. Of these, 11 studies that examined 15 cohorts were combined by meta‐analysis reporting on four health outcomes: cognitive impairment (n=6,458), dementia (n=9,955), falls (n=12,640), and mortality (n=19,818). Risk of bias was deemed low‐to‐moderate in all studies except one, where falls was the outcome. Our meta‐analysis found that participants with MCR were at an increased risk of cognitive impairment (adjusted hazard ratio (aHR) 1.76, 95%CI 1.49–2.08; I2=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%), see figure 1. Conclusion: Evidence suggests that participants with MCR at baseline are at an increased risk of cognitive impairment, dementia, falls, and mortality on follow‐up. [ABSTRACT FROM AUTHOR]