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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 explored the association between MCR and socioeconomic status, as determined by occupational social class and years of education. Methods: Some 692 community‐based adults of the Lothian Birth Cohort 1936 (LBC1936), aged 70 years at baseline, were followed up after 6 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 versus 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 three‐fold increased likelihood of MCR (adjusted odds ratio 3.55, 95% CI 1.46–8.74; p = 0.005) compared with those of higher socioeconomic status (non‐manual occupation). Conclusions: 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. [ABSTRACT FROM AUTHOR]

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]

Objectives: Motoric Cognitive Risk (MCR) is a gait-based predementia syndrome that is easy to measure and prognostic of dementia and falls. We aimed to examine the prevalence and risk factors for MCR, and assess its overlap with Mild Cognitive Impairment, Prefrailty, and Frailty, in a cohort of older Scottish adults without dementia.Methods: In this longitudinal prospective study, we classified 690 participants (mean [SD] age 76.3 [0.8] years; wave 3) of the Lothian Birth Cohort 1936 (LBC1936) into non-MCR or MCR groups. We examined their baseline (age 69.5 [0.8] years; wave 1) risk factors for MCR at waves 3, 4, and 5 (6, 9, and 12 years later respectively).Results: MCR prevalence rate ranged from 5.3% to 5.7% across the three waves. The presence of MCR was associated with older baseline age (6 and 9 years later), lower occupational socioeconomic status (6 years later), and worse scores in a range of tests of executive function (6, 9 and 12 years later). Approximately 46% of the MCR group also had Mild Cognitive Impairment, and almost everyone in the MCR group had either Prefrailty or Frailty.Conclusions: The prevalence of MCR in this Scottish cohort is lower than the pooled global average, possibly reflecting the general good health of the LBC cohort. However, it is higher than the prevalence in two neighbouring countries' cohorts, which may reflect the younger average ages of those cohorts. Future LBC1936 research should assess the risk factors associated with MCR to validate previous findings and analyse novel predictive factors, particularly socioeconomic status. [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 and Objectives There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education. Research Design and Methods We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term. Results Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves. Discussion and Implications Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions. [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) describes a borderland between healthy cognition and dementia. Progression to and reversion from MCI is relatively common but more research is required to understand the factors affecting this fluidity and improve clinical care interventions.Objective: We explore these transitions in MCI status and their predictive factors over a six-year period in a highly-phenotyped longitudinal study, the Lothian Birth Cohort 1936.Methods: MCI status was derived in the LBC1936 at ages 76 (n = 567) and 82 years (n = 341) using NIA-AA diagnostic guidelines. Progressions and reversions between healthy cognition and MCI over the follow-up period were assessed. Multinomial logistic regression assessed the effect of various predictors on the likelihood of progressing, reverting, or maintaining cognitive status.Results: Of the 292 participants who completed both time points, 41 (14%) participants had MCI at T1 and 56 (19%) at T2. Over the follow-up period, 74%remained cognitively healthy, 12%transitioned to MCI, 7%reverted to healthy cognition, and 7%maintained their baseline MCI status. Findings indicated that membership of these transition groups was affected by age, cardiovascular disease, and number of depressive symptoms.Conclusion: Findings that higher baseline depressive symptoms increase the likelihood of reverting from MCI to healthy cognition indicate that there may be an important role for the treatment of depression for those with MCI. However, further research is required to identify prevention strategies for those at high risk of MCI and inform effective interventions that increase the likelihood of reversion to, and maintenance of healthy cognition. [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]

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., (© 2021 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)