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Keywords = motoric cognitive risk syndrome (MCR)

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15 pages, 1669 KiB  
Article
Predicting Cognitive Decline in Motoric Cognitive Risk Syndrome Using Machine Learning Approaches
by Jin-Siang Shaw, Ming-Xuan Xu, Fang-Yu Cheng and Pei-Hao Chen
Diagnostics 2025, 15(11), 1338; https://doi.org/10.3390/diagnostics15111338 - 26 May 2025
Viewed by 527
Abstract
Background: Motoric Cognitive Risk Syndrome (MCR), defined by the co-occurrence of subjective cognitive complaints and slow gait, is recognized as a preclinical risk state for cognitive decline. However, not all individuals with MCR experience cognitive deterioration, making early and individualized prediction critical. [...] Read more.
Background: Motoric Cognitive Risk Syndrome (MCR), defined by the co-occurrence of subjective cognitive complaints and slow gait, is recognized as a preclinical risk state for cognitive decline. However, not all individuals with MCR experience cognitive deterioration, making early and individualized prediction critical. Methods: This study included 80 participants aged 60 and older with MCR who underwent baseline assessments including plasma biomarkers (β-amyloid, tau), dual-task gait measurements, and neuropsychological tests. Participants were followed for one year to monitor cognitive changes. Support Vector Machine (SVM) classifiers with different kernel functions were trained to predict cognitive decline. Feature importance was evaluated using the weight coefficients of a linear SVM. Results: Key predictors of cognitive decline included plasma β-amyloid and tau concentrations, gait features from dual-task conditions, and memory performance scores (e.g., California Verbal Learning Test). The best-performing model used a linear kernel with 30 selected features, achieving 88.2% accuracy and an AUC of 83.7% on the test set. Cross-validation yielded an average accuracy of 95.3% and an AUC of 99.6%. Conclusions: This study demonstrates the feasibility of combining biomarker, motor, and cognitive assessments in a machine learning framework to predict short-term cognitive decline in individuals with MCR. The findings support the potential clinical utility of such models but also underscore the need for external validation. Full article
(This article belongs to the Special Issue Artificial Intelligence in Biomedical Imaging and Signal Processing)
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12 pages, 864 KiB  
Article
Healthy Behavior for Preventing Cognitive Disability in Older Persons
by Fulvio Lauretani, Antonio Marcato and Crescenzo Testa
Int. J. Environ. Res. Public Health 2025, 22(2), 262; https://doi.org/10.3390/ijerph22020262 - 12 Feb 2025
Viewed by 1255
Abstract
Sufficient levels of physical activity are fundamental for preventing cardiovascular disease, dementia, and ultimately disability in older persons, yet this protective factor is nullified when excessive hours are spent in continuous sitting. Balancing physical activity and sedentary behavior is crucial for influencing metabolic [...] Read more.
Sufficient levels of physical activity are fundamental for preventing cardiovascular disease, dementia, and ultimately disability in older persons, yet this protective factor is nullified when excessive hours are spent in continuous sitting. Balancing physical activity and sedentary behavior is crucial for influencing metabolic parameters and vascular patterns, both central and peripheral, thereby reducing the risk of cardiovascular diseases, vascular dementia, and cognitive impairment. The primary goal of geriatric medicine is to improve quality of life and prevent disability by promptly identifying frail older individuals, thus mitigating both cognitive and motor impairments. Achieving this objective requires not only the optimization of pharmacological treatments but also the active promotion of a healthy lifestyle. In this context, investigating preclinical stages of disability, such as Motoric Cognitive Risk (MCR) Syndrome, which integrates physical and cognitive components of decline, becomes essential. However, despite robust evidence supporting these interventions, greater efforts are needed from the geriatric medical community to bridge the gap between scientific recommendations and everyday clinical practice. Integrating these guidelines into routine care is pivotal for delivering personalized interventions that address both physical inactivity and prolonged sedentary behavior. More research should aim to strengthen this balance, providing clearer, actionable strategies for clinicians to implement, thereby fostering the formation of evidence-based public health guidelines on physical activity specifically tailored for older persons. Full article
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12 pages, 415 KiB  
Article
Association between Motoric Cognitive Risk Syndrome and Indicators of Reflecting Independent Living among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study
by Koji Takimoto, Hideaki Takebayashi, Yoshiyuki Yoshikawa, Hiromi Sasano, Soma Tsujishita and Koji Ikeda
Healthcare 2024, 12(18), 1808; https://doi.org/10.3390/healthcare12181808 - 10 Sep 2024
Viewed by 1727
Abstract
The purpose of this study was to examine whether motoric cognitive risk syndrome (MCR) is associated with various indicators of independent living among community-dwelling older adults in Japan. The study design was a cross-sectional study, and the participants were 107 community-dwelling older adults [...] Read more.
The purpose of this study was to examine whether motoric cognitive risk syndrome (MCR) is associated with various indicators of independent living among community-dwelling older adults in Japan. The study design was a cross-sectional study, and the participants were 107 community-dwelling older adults (mean age 79 ± 7 years) who were living independently. The participants were administered the Questionnaire for Medical Checkup of Old-Old (QMCOO) as an indicator of health status and the Japan Science and Technology Agency Index of Competence (JST-IC) as an indicator of higher levels of functioning capacity, among others. In addition, we assessed physical frailty (J-CHS), sarcopenia (AWGS2019), and MCR (slow gait + subjective memory complaints), which are predictors of adverse events in the elderly. Multiple regression analysis with QMCOO as the response variable showed that MCR (p = 0.01, β: 0.25) and physical frailty (p < 0.01, β: 0.43) were significantly associated. In addition, analysis with JST-IC as the response variable showed that MCR (p = 0.03, β: −0.20), physical frailty (p = 0.01, β: −0.24) and age (p = 0.02, β: −0.21) were significantly associated. In conclusion, MCR was found to be similarly associated with QMCOO and JST-IC as physical frailty. It is expected that the MCR will be used as an initial screening tool to identify signs of risk in community-dwelling older people, as it is easy to diagnose. Full article
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13 pages, 611 KiB  
Article
Association of Motoric Cognitive Risk Syndrome with Sarcopenia and Systemic Inflammation in Pre-Frail Older Adults
by Reshma Aziz Merchant, Yiong Huak Chan, Denishkrshna Anbarasan and Ivan Aprahamian
Brain Sci. 2023, 13(6), 936; https://doi.org/10.3390/brainsci13060936 - 9 Jun 2023
Cited by 15 | Viewed by 3795
Abstract
Motoric cognitive risk syndrome (MCR) is defined by the presence of slow gait and subjective cognitive decline. It is well recognized as a prodrome for dementia, but the biological mechanism and trajectory for MCR are still lacking. The objective of this study was [...] Read more.
Motoric cognitive risk syndrome (MCR) is defined by the presence of slow gait and subjective cognitive decline. It is well recognized as a prodrome for dementia, but the biological mechanism and trajectory for MCR are still lacking. The objective of this study was to explore the association of MCR with body composition, including sarcopenia and systemic inflammation, in pre-frail older adults in a cross-sectional study of 397 pre-frail community-dwelling older adults. Data on demographics, physical function, frailty, cognition (Montreal Cognitive Assessment (MoCA)), perceived health and depression were collected. Body composition was measured using a bioelectrical impedance analyzer. Systemic inflammatory biomarkers, such as progranulin, growth differentiation factor-15 (GDF-15), interleukin-10 (IL-10), interleukin-6 and tumor necrosis factor-α (TNF-α), were collected. Univariate and multivariate logistic regression were used to analyze the association between MCR, body composition, sarcopenia and systemic inflammatory biomarkers. The prevalence of MCR was 14.9%. They were significantly older and there were more females, depression, functional impairment, lower education, physical activity and MoCA scores. Body fat percentage (BF%), fat mass index, fat to fat free mass ratio (FM/FFM) and sarcopenia prevalence were significantly higher in MCR. Serum GDF-15 and TNF-α levels were highest with progranulin/TNF-α and IL-10/TNF-α ratio lowest in MCR. Compared to healthy patients, MCR was significantly associated with sarcopenia (aOR 2.62; 95% CI 1.46–3.17), BF% (aOR 1.06; 95% CI 1.01–1.12), FMI (aOR 1.16; 95% CI 1.02–1.30) and FM/FFM (aOR 6.38; 95% CI 1.20–33.98). The association of IL-10 to TNF-α ratio (aOR 0.98, 95% CI 0.97–0.99) and IL-10 (aOR 2.22, 95% CI 0.05–0.98) with MCR were independent of sarcopenia and BF%. Longitudinal population studies are needed to understand the role of body fat indices and IL-10 in pre-frail older adults with MCR and trajectory to dementia. Full article
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8 pages, 341 KiB  
Article
Vitamin D Concentration and Motoric Cognitive Risk in Older Adults: Results from the Gait and Alzheimer Interactions Tracking (GAIT) Cohort
by Maxime Le Floch, Jennifer Gautier and Cédric Annweiler
Int. J. Environ. Res. Public Health 2022, 19(20), 13086; https://doi.org/10.3390/ijerph192013086 - 12 Oct 2022
Cited by 10 | Viewed by 1970
Abstract
Background. Motoric Cognitive Risk (MCR) syndrome, which combines subjective memory complaint (SMC) and slower gait speed, is a newly-described predementia stage. Based on the involvement of vitamin D in the biology of both gait and cognition, we hypothesized that nondemented individuals with MCR [...] Read more.
Background. Motoric Cognitive Risk (MCR) syndrome, which combines subjective memory complaint (SMC) and slower gait speed, is a newly-described predementia stage. Based on the involvement of vitamin D in the biology of both gait and cognition, we hypothesized that nondemented individuals with MCR would exhibit hypovitaminosis D more often compared to Cognitively Healthy Individuals (CHI). The objective of this cross-sectional analysis was to determine whether hypovitaminosis D was associated with MCR. Methods. Participants without dementia from the GAIT (Gait and Alzheimer Interactions Tracking) cohort study were classified into MCR or Cognitively Healthy Individuals (CHI) groups. Hypovitaminosis D was defined as the lowest quartile of serum 25-hydroxyvitamin D (25OHD) concentration compared to the other three combined. Age, sex, body mass index (BMI), the Frontal Assessment Battery (FAB) score, the Mini-Mental Short Examination (MMSE) score, education level, use of psychoactive drugs, and the number of chronic diseases were used as covariates. Results. Among 244 nondemented and nonMCInonMCR participants from the GAIT cohort (mean age 71.4 ± 3.7 years, 40.6% women), 66 participants were classified as MCR (36.9%) and 178 as CHI (63.1%). The lowest quartile of 25OHD concentration was directly associated with MCR (unadjusted OR = 2.85, p = 0.003) even after adjustment for studied potential confounders (fully adjusted OR = 2.61, p = 0.025). The BMI (adjusted OR = 6.65, p < 0.001), MMSE score (adjusted OR = 0.74, p = 0.009), FAB score (adjusted OR = 0.51, p < 0.001), number of chronic diseases (adjusted OR = 1.29, p = 0.043) and use of psychoactive drugs (adjusted OR = 2.55, p = 0.044) were also associated with MCR. Conclusions. Hypovitaminosis D was associated with MCR in older community-dwellers without dementia. Full article
(This article belongs to the Special Issue Cognitive Impairment and Gait Disorders in Older Adults)
10 pages, 715 KiB  
Article
Mediation Analyses of the Role of Apathy on Motoric Cognitive Outcomes
by Mirnova E. Ceïde, Daniel Eguchi, Emmeline I. Ayers, David W. Lounsbury and Joe Verghese
Int. J. Environ. Res. Public Health 2022, 19(12), 7376; https://doi.org/10.3390/ijerph19127376 - 16 Jun 2022
Cited by 7 | Viewed by 2647
Abstract
Recent literature indicates that apathy is associated with poor cognitive and functional outcomes in older adults, including motoric cognitive risk syndrome (MCR), a predementia syndrome. However, the underlying biological pathway is unknown. The objectives of this study were to (1) examine the cross-sectional [...] Read more.
Recent literature indicates that apathy is associated with poor cognitive and functional outcomes in older adults, including motoric cognitive risk syndrome (MCR), a predementia syndrome. However, the underlying biological pathway is unknown. The objectives of this study were to (1) examine the cross-sectional associations between inflammatory cytokines (Interleukin 6 (IL-6) and C-Reactive Protein (CRP)) and apathy and (2) explore the direct and indirect relationships of apathy and motoric cognitive outcomes as it relates to important cognitive risk factors. N = 347 older adults (≥65 years old) enrolled in the Central Control of Mobility in Aging Study (CCMA). Linear and logic regression models showed that IL-6, but not CRP was significantly associated with apathy adjusted for age, gender, and years of education (β = 0.037, 95% CI: 0.002–0.072, p = 0.04). Apathy was associated with a slower gait velocity (β = −14.45, 95% CI: −24.89–4.01, p = 0.01). Mediation analyses demonstrated that IL-6 modestly mediates the relationship between apathy and gait velocity, while apathy mediated the relationships between dysphoria and multimorbidity and gait velocity. Overall, our findings indicate that apathy may be an early predictor of motoric cognitive decline. Inflammation plays a modest role, but the underlying biology of apathy warrants further investigation. Full article
(This article belongs to the Special Issue Innovations in Healthy Aging)
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16 pages, 1253 KiB  
Article
Motoric Cognitive Risk Syndrome Using Three-Item Recall Test and Its Associations with Fall-Related Outcomes: The Korean Frailty and Aging Cohort Study
by Hayoung Shim, Miji Kim and Chang Won Won
Int. J. Environ. Res. Public Health 2020, 17(10), 3364; https://doi.org/10.3390/ijerph17103364 - 12 May 2020
Cited by 12 | Viewed by 3537
Abstract
Motoric cognitive risk (MCR) syndrome is originally defined as the presence of subjective cognitive complaints (SCCs) and slow gait (SG). MCR is well known to be useful for predicting adverse health outcomes, including falls and dementia. However, around four out of five older [...] Read more.
Motoric cognitive risk (MCR) syndrome is originally defined as the presence of subjective cognitive complaints (SCCs) and slow gait (SG). MCR is well known to be useful for predicting adverse health outcomes, including falls and dementia. However, around four out of five older Korean adults reported SCCs, thereby, it may not be discriminative to define MCR in Korea. We adopted the three-item recall (3IR) test, instead of SCCs, to define MCR. This cross-sectional analysis included 2133 community-dwelling older adults aged 70–84 years, without dementia or any dependence in activities of daily living from the Korean Frailty and Aging Cohort Study. The newly attempted criteria of MCR using 3IR were met by 105 participants (4.9%). MCR using 3IR showed synergistic effects on fall-related outcomes, whereas the conventional definition of MCR using SCCs was not superior to SG only. MCR using 3IR was associated with falls (odds ratio [OR]: 1.92; 95% confidence interval (CI): 1.16–3.16), recurrent falls (OR: 2.19; 95% CI: 1.12–4.32), falls with injury (OR: 1.98; 95% CI: 1.22–3.22), falls with fracture (OR: 2.51; 95% CI: 1.09–5.79), fear of falling (OR: 3.00; 95% CI: 1.83–4.92), and low activities-specific balance confidence (OR: 3.13; 95% CI: 1.57–6.25). We found that MCR using 3IR could be useful in predicting fall-related outcomes in a cultural background reporting more SCCs, such as Korea. Full article
(This article belongs to the Special Issue Prevention and Management of Frailty)
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