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Updated: Nov 24, 2025
Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
Published on: November 7, 2014
Slow Gait, Subjective Cognitive Decline and Motoric Cognitive RISK Syndrome: Prevalence and Associated Factors in
Reshma A Merchant1, J Goh, Y H Chan
1Associate Professor Reshma Merchant, Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore 119228, Email: reshmaa@nuhs.edu.sg, Telephone number: +65 6779 5555, ORCID iD: 0000-0002-9032-0184.
Background:
Motoric Cognitive Risk Syndrome (MCR), slow gait speed (SG) and subjective cognitive decline (SCD) are known to be harbingers of dementia. MCR is known to be associated with a 3-fold increased risk of future dementia, while SG can precede cognitive impairment.
Objective:
We aim to determine the prevalence and demographics of MCR, slow gait alone (SG-A) and subjective cognitive decline alone (SCD-A) in community-dwelling older adults and association with physical, functional, cognition and psychosocial factors.
Methods:
A total of 509 participants were classified into four groups according to presence of SG and/or SCD. Multinomial logistic regression was used to identify the factors associated with SG-A, SCD-A and MCR.
Results:
The prevalence of MCR was 13.6%, SG-A 13.0% and SCD-A 35.0%. Prevalence of MCR doubled every decade in females with 27.7% of female ≥ 80 years old had MCR. Almost 4 in 10 had no SG or SCD (SG+SCD negative). MCR and SG-A groups were significantly older, had higher body mass index (BMI), lower education, lower global cognition scores especially in non-memory domains, higher prevalence of low grip strength and lower short physical performance battery scores than those with SCD-A and SG+SCD negative. In addition, the SG-A group had significantly higher prevalence of multi-morbidity and diabetes. The prevalence of pain, depression, frailty, social isolation and activity of daily living impairment were significantly higher in MCR. The global cognitive and functional scores for those with SCD-A were comparable to the SG+SCD negative group. The Malay ethnic group had the lowest prevalence of SCD but highest prevalence of SG. After adjusting for confounding factors, age, BMI, frailty status, instrumental activity of daily living, depression and pain remained significantly associated with MCR. For SG-A, age, BMI, education and number of chronic diseases remained significant.
Conclusion:
Both MCR and SG-A are associated with global cognitive decline especially in the non-memory domains and lower functional scores. Gait speed is a good predictor of negative outcomes and should be considered as the 'sixth' vital sign. Long term prospective studies are needed to evaluate: i) the conversion to dementia in different ethnic groups and ii) effect of targeted physical and / or dual task exercise on delaying the conversion to dementia and / or improvement in physical measures and reduction of disability.
Insights
Motoric Cognitive Risk Syndrome (MCR) and slow gait speed (SG) are linked to cognitive decline in older adults. Gait speed is a crucial indicator for negative health outcomes.
Area of Science:
- Gerontology
- Neurology
- Public Health
Background:
- Motoric Cognitive Risk Syndrome (MCR), slow gait speed (SG), and subjective cognitive decline (SCD) are recognized early indicators of dementia.
- MCR is associated with a threefold increased risk of future dementia, and SG can precede cognitive impairment.
Purpose of the Study:
- To determine the prevalence and demographics of MCR, SG alone (SG-A), and SCD alone (SCD-A) in community-dwelling older adults.
- To investigate the associations of MCR, SG-A, and SCD-A with physical, functional, cognitive, and psychosocial factors.
Main Methods:
- 509 participants were classified into four groups based on the presence of SG and/or SCD.
- Multinomial logistic regression analysis was employed to identify factors associated with SG-A, SCD-A, and MCR.
Main Results:
- Prevalence rates were MCR: 13.6%, SG-A: 13.0%, and SCD-A: 35.0%. MCR prevalence doubled per decade in females.
- MCR and SG-A groups were older, had higher BMI, lower education, poorer cognition (especially non-memory domains), lower grip strength, and lower physical performance scores.
- MCR was linked to higher prevalence of pain, depression, frailty, social isolation, and ADL impairment. SG-A was associated with increased multi-morbidity and diabetes.
Conclusions:
- Both MCR and SG-A are associated with global cognitive decline, particularly in non-memory domains, and reduced functional scores.
- Gait speed is a significant predictor of adverse outcomes and should be considered a vital sign.
- Further research is needed to explore dementia conversion across ethnic groups and the impact of interventions on physical measures and disability.
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