Motoric Cognitive Risk Syndrome and Falls Risk: A Multi-Center Study

Background: The Motoric Cognitive Risk Syndrome (MCR) is characterized by slow gait speed and cognitive complaints. Objectives: The objective of this study was to determine if the presence of MCR increases the risk of falls in older people. Methods: Individual participant data (n=6,204) from five longitudinal studies from three countries were used for this analysis. MCR diagnosis was defined as both the presence of objectively measured slow gait speed and subjective cognitive complaints in those without dementia or mobility disability. Falls were prospectively ascertained using phone calls or questionnaires. Log binomial regression was performed to determine if MCR increased the risk of falls separately in each cohort. Random effects meta-analysis was used to pool results from all cohorts. Results: The mean age of participants was 74.9 (SD 6.8) years and 44 (n=2728) were male. Overall 33.9 (n=2104) reported a fall over follow-up. Pooled relative risk of MCR with any falls was RR 1.44 95 CI 1.16, 1.79. The components of MCR, slow gait (RR 1.30 95 CI 1.14, 1.47) and cognitive complaint (RR 1.25, 95 CI 1.07, 1.46) were also associated with an increased risk of any falls. In sub-analyses MCR was associated with any fall independent of previous falls (RR 1.29 95 CI 1.09, 1.53) and with multiple falls (RR 1.77, 95 CI 1.25, 2.51). Conclusion: MCR is associated with an increased risk of falls. The increase in risk was higher than for its individual components. The simplicity of the MCR makes it an attractive falls risk screening tool for the clinic.