Longitudinal association between falls and motoric cognitive risk syndrome among community-dwelling older adults

A significant predictor of cognitive decline and dementia in older adults is the motoric cognitive risk (MCR) syndrome, a recently discovered dementia syndrome defined by subjective cognitive complaint and sluggish gait.1 Early detection may develop cognitive decline or dementia with more potent therapies and a better prognosis, but current early screening tests and underlying pathogenesis remains poorly understood, especially for MCR detection. Early studies showed that falls in walking predicted cognitive decline and dementia.1 Thus, Falls may be one such simple and informative early screening test for MCR. However, to our knowledge, no previous study has yet tested whether falls frequency is related to MCR among Chinese older adults.

Cognitive impairment has been noted in clinical practice guidelines as a fall risk factor, particularly for older adults suffering from functional decline, fracture, disability, reduced quality of life, and increased mortality.2 Multiple populations have reported that MCR syndrome and falls are related, including Korean3 and New Zealand.4 Furthermore, this association remains uncertain in the Chinese population. Notably, the only cross-sectional studies published in China have shown that falls are associated with MCR,5 it is yet unknown whether falls also predict MCR. The relationship between MCR and falls in various groups may vary depending on a variety of factors, including potential variations in health problems and variations in behavioral, cultural, and lifestyle factors. Therefore, it is crucial to ascertain whether MCR is indeed connected to falls across various groups, and whether this connection varies between them. Understanding the pathophysiological mechanisms underlying MCR will be aided by showing that falls are related to MCR in Chinese older adults. This information may also be useful clinically for the early detection and prevention of MCR in those who are at risk.

We have the opportunity with the baseline assessment of a large population-based observational, prospective study in China—the China Health and Retirement Longitudinal Study (CHARLS)—to better understand the parameters influencing the association of falls with MCR. It was proposed that older persons who experience falls, especially multiple falls, may be more likely to develop MCR. The additional analysis tested whether microsystem factors (age, gender, and BMI), meso/ exosystem factors (sleep disturbance, drinking, smoking, chronic disease, married, education level, and physical activity), and macrosystem factors (sleep disturbance, drinking, smoking, chronic disease, married, education level, and physical activity) accounted for the association between falls and MCR.

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