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Motoric Cognitive Risk Syndrome and Risk for Falls, Their Recurrence, and Postfall Fractures: Results From a
Olivier Beauchet1, Harmehr Sekhon2, Anne-Marie Schott3
1Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Dr Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Objective:
Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and its components [ie, slow walking speed and subjective cognitive complaint (SCC)] with the occurrence of falls, their recurrence, and postfall fractures in older community-dwelling adults.
Design:
Observational prospective and longitudinal cohort study.
Setting And Participants:
French community-dwelling older women (n = 5958) recruited in the EPIDémiologie de l'OStéoporose (EPIDOS) study.
Measures:
MCR was defined as both the presence of SCC and slow walking speed in women free of major neurocognitive disorders. Falls (≥1), recurrent falls (≥2), and postfall fractures (any fractures and hip fractures) were prospectively recorded using mail and/or phone call questionnaires every 4 months over 4 years.
Results:
At baseline, the prevalence of SCC was 43.1% (n = 2569), slow walking speed 5.7% (n = 341), and MCR 9.9% (n = 591). Overall, 25.7% (n = 1533) of participants reported any fall during the follow-up. The incidence of postfall hip fractures was higher in participants with MCR compared to healthy participants and those with SCC (P ≤ .001). Cox regression models revealed that only participants with MCR had a significantly high risk for falls [hazard ratio (HR) = 1.22, P = .021], recurrent falls (HR = 1.46 with P = .030), and postfall hip fractures (HR = 2.54, P ≤ .001).
Conclusions/Implications:
There is an increased risk for falls, their recurrence, and postfall hip fractures associated with MCR but not with its individual components. This finding underscores the clinical interest of MCR for the detection of older adults at risk for falls and their related adverse events in order to start early appropriate interventions for fall reduction.
Insights
Motoric cognitive risk syndrome (MCR) increases the risk of falls, recurrent falls, and hip fractures in older adults. Early detection of MCR is crucial for fall prevention and reducing adverse events.
Area of Science:
- Gerontology
- Neurology
- Epidemiology
Background:
- Motoric cognitive risk syndrome (MCR) is a predementia stage linked to fall risk.
- Previous studies show conflicting results on MCR's association with recurrent falls and lack data on postfall fractures.
Purpose of the Study:
- To investigate the association between MCR, its components (slow walking speed and subjective cognitive complaint), and the occurrence of falls, recurrent falls, and postfall fractures in older adults.
Main Methods:
- An observational prospective longitudinal cohort study involving 5958 French community-dwelling older women.
- MCR was defined by subjective cognitive complaint and slow walking speed.
- Falls, recurrent falls, and postfall fractures were prospectively recorded over 4 years.
Main Results:
- MCR was present in 9.9% of participants at baseline.
- Participants with MCR showed a significantly higher risk for falls (HR=1.22), recurrent falls (HR=1.46), and postfall hip fractures (HR=2.54).
- Individual components of MCR were not significantly associated with these outcomes.
Conclusions:
- MCR is associated with an increased risk of falls, recurrent falls, and postfall hip fractures in older adults.
- MCR, not its individual components, predicts these adverse events.
- MCR is a valuable clinical indicator for identifying older adults at high risk for falls and related injuries, enabling timely interventions.
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