Characterizing motoric cognitive risk syndrome beyond traditional criteria

Motoric cognitive risk (MCR) syndrome is defined by slow gait speed and cognitive complaints. This study aimed to identify objective gait, cognitive, and psychosocial markers that characterize MCR beyond its traditional criteria. 104 older adults were classified into four groups: healthy aging (n = 50), slow gait speed only (n = 31), cognitive complaints only (n = 13), and MCR (n = 10). Participants completed single- and dual-task gait assessments while wearing wearable gait sensors. The dual-task paradigm involved responding to auditory stimuli while walking. Cognitive performance was measured using the Montreal Cognitive Assessment (MoCA) and reaction time on the cognitive "oddball" task. Psychosocial measures included psychological resilience, cognitive reserve, and balance confidence. Linear mixed models compared group differences across conditions on gait variables and reaction time. One-way ANOVA tested group differences in cognitive and psychosocial measures. In single-task walking, individuals with MCR showed greater variability in single-limb support compared to healthy older adults, but not compared to those with slow gait or cognitive complaints. Reaction time impairments were observed in MCR during single-task conditions relative to healthy aging and cognitive complaints. MoCA scores and psychological resilience were lower in MCR compared to healthy aging and slow gait speed, but not cognitive complaints. Balance confidence was the only measure that distinguished MCR from all other groups. Older adults with MCR show the highest burden in gait, cognitive, and psychosocial tests. However, only reduced balance confidence uniquely distinguished MCR from all other groups. Further research should explore targeted rehabilitation strategies to improve balance confidence and assess their impact on MCR progression and functional outcomes.