Gait, Cognition and Associated Risk Factors: Insights from SHARE and TILDA

<div> <div> <div> <p>INTRODUCTION </p> <p>The established pathway of cognitive decline identifies Mild Cognitive Impairment (MCI) as a common pre-dementia syndrome. As MCI can represent the endpoint of cognitive decline or a transient state, more predictive diagnostic tools are required. A new pre-dementia syndrome, Motoric Cognitive Risk (MCR) syndrome, has been proposed. It is defined as a slow gait and cognitive complaints but, without dementia and mobility disability. MCR aims to improve on MCI, this study aims to explore it’s claim. </p> <p>Associations have been uncovered between differing cognitive domains and specific characteristics of gait. Leveraging the gait-cognitive function relationship is a novel approach to potentially highlighting those experiencing cognitive decline. However the diagnostic tool of MCR is a new construct and currently imperfect, its efficacy not fully validated and sensitivity for dementia prediction relatively unknown. Reliable data on prevalence and risk factors help contribute to this validation process. </p> <p>In a multi-country study, pooled MCR prevalence was found to be 9.7%. Information is needed to gain a reliable insight into Irish prevalence, associations and underlying etiologies. Notable risk factors previously identified in global studies include obesity, depressive symptoms, strokes and sedentariness. </p> <p>STUDY OBJECTIVES </p> <p>Firstly, to determine the prevalence of MCR in a cross-sectional dataset representative of the Irish population over 50 years of age (TILDA: The Irish Longitudinal Study on Ageing) and longitudinally in a European multi-country population study (SHARE: Survey of Health. Ageing and Retirement in Europe). Secondly, to investigate the relationship between gait speed and cognitive decline longitudinally in the SHARE dataset, including the presence of potential risk factors. The primary hypothesis for this objective is that there is a measureable decrease in cognitive function in those who demonstrated slow gait at an earlier stage in the study. </p> <p>EXPERIMENTAL DESIGN </p> </div> <div> <p>function relationship and associated risk factors in older adults will be completed in order to guide the research methodology. The hypotheses above will be examined through statistical mathematical modelling, relying primarily on univariate regression analysis. The interaction between gait, cognition and risk factors identified previously in the literature will be examined. Stata 14 IC will be employed for the computational analysis of a nationally representative (TILDA) and a multi-country (SHARE) dataset. </p> <p>The variables available in both datasets which will be of interest in this study include; Gait Speed, Global Cognition (Mini-Mental State Exam (MMSE) score), Presence of Cognitive Complaints, Age, Body Mass Index (BMI), Dementia diagnosis (reported or imputed) and Waist Circumference. </p> <p>RESEARCH IMPACT & SIGNIFICANCE </p> <p>Over the next 35 years, the population of people living with dementia is projected to nearly triple to more than 130 million. Given this increase, the global cost of dementia is estimated to increase to more than $1 trillion by 2030. </p> <p>Evidence in some countries suggesting that annual Dementia incidence is plateauing emphasizes the benefit of good physical and cognitive health in middle age. Therefore, increasingly predictive and longer-range screening tools would add greatly to patient management. Not least in the early implementation of potential prevention strategies for the targetable risk factors previously listed. However, prior to considering use of MCR in this clinical scenario, validation and reliable prevalence in a community dwelling elderly population is required. </p> </div> </div>