February 28, 2020
For older adults without dementia who are experiencing declines in both memory and gait, researchers found this patient population is at a higher risk of developing dementia and “may be a group to target for prevention.” The findings of this study were published online in JAMA Network Open.
“Identifying persons who experience both mobility decline and memory decline, a main symptom in the early stage of dementia, may have a greater prognostic value in assessing risk of dementia because the combination could identify a group in whom gait speed decline is at least in part caused by neurodegenerative pathologic conditions of the central nervous system rather than local musculoskeletal problems, such as sarcopenia or osteoarthritis,” explained Qu Tian, PhD, MS, National Institute on Aging, and colleagues.
In order to understand the risk of dementia in older adults who were experiencing declines in memory and gait speed, Dr Tian and colleagues conducted a multicohort meta-analysis of 6 prospective cohort studies. The studies analyzed were conducted between 1997 and 2018 in the United States and Europe.
Of the 6 analyzed studies, Dr Tian and colleagues identified 8699 participants. Among these participants, the mean age range was between 70 and 74 years and the mean gait speed ranged between 1.05 and 1.26 m/s.
“Incident dementia ranged from 5 to 21 per 1000 person-years,” they noted.
According to the study findings, study participants with memory decline only had a 2.2 to 4.6 times higher risk for developing dementia (pooled hazard ratio, 3.45 [95% CI, 2.45-4.86]) compared with usual aging adults. Further, participants experiencing decline in gait only had 2.1 to 3.6 times higher risk (pooled hazard ratio, 2.24 [95% CI, 1.62-3.09]).
Of important note, participants experiencing decline in both memory and gait had 5.2 to 11.7 times the risk (pooled hazard ratio, 6.28 [95% CI, 4.56-8.64]).
“Although participants with gait decline also showed some increased risk of dementia, when accompanied by a parallel decline in objective memory, the risk of developing dementia tended to be the highest among phenotypic groups,” Dr Tian and colleagues concluded.
“Our finding that participants with dual decline are at particularly high risk of developing dementia supports the importance of the unique occurring symptom of cognitive and motor deficits outlined in previous research on motoric cognitive risk syndrome and further establishes its clinical relevance.”
Tian Q, Resnick SM, Mielke MM, et al. Association of dual decline in memory and gait speed with risk for dementia among adults older than 60 years: a multicohort individual-level meta-analysis [published online February 21, 2020]. JAMA Netw Open. 2020;3(2):e1921636. doi:10.1001/jamanetworkopen.2019.21636