Motoric Cognitive Risk Syndrome Associated With Risk of Frailty and Likelihood of Reversion in Older Adults.

BACKGROUND: Motoric cognitive risk syndrome (MCR), a predementia condition, is reported to be associated with frailty. However, the associations of MCR with frailty risk and its reversibility remain unclear.

METHODS: A longitudinal study was conducted of 10 809 older adults from the Health and Retirement Study in the United States. Frailty was assessed by the frailty index and reversibility was measured by transitions from frailty at baseline to non-frailty during follow-up. MCR was defined as the presence of both subjective cognitive complaints and slow gait speed in individuals without dementia or mobility disability. Multistate Markov models were performed to evaluate the effects of MCR on transitions among non-frailty, frailty and death. Cox regression models were used to estimate MCR associated with the risk of frailty and the likelihood of reversion.

RESULTS: Among 10 809 participants with a median age of 71 (interquartile range: 67-71) years and 6462 (57.93%) females, a total of 105 372 person-years (9.75 years in average) were followed up. The prevalence of MCR at baseline in non-frail and frail participants was 3.12% and 18.56%, respectively. Compared with non-MCR, MCR increased the probability of transitioning from non-frailty to frailty by 46% (HR = 1.46, 95% CI: 1.27-1.67) and decreased the probability of transitioning from frailty to non-frailty by 36% (HR = 0.64, 95% CI: 0.52-0.77). Compared with normal function, subjective cognitive complaints only, slow gait speed only and MCR increased the probability of transitioning from non-frailty to frailty by 43% (HR = 1.43, 95% CI: 1.33-1.53), 14% (HR = 1.14, 95% CI: 1.00-1.30) and 69% (HR = 1.69, 95% CI: 1.47-1.96) and decreased the probability of transitioning from frailty to non-frailty by 18% (HR = 0.82, 95% CI: 0.74-0.92), 27% (HR = 0.73, 95% CI: 0.60-0.88) and 45% (HR = 0.55, 95% CI: 0.45-0.67), respectively. As shown in the prospective analyses, MCR and its single component were associated with increased frailty risk and decreased likelihood of reversion.

CONCLUSIONS: MCR is associated with an increased risk of frailty, accelerated transition from non-frailty to frailty and a decreased likelihood of reversion from frailty. MCR emerges as a promising risk stratification factor for frailty, highlighting the need for increased focus on individuals with MCR, particularly within the pre-frail population.