Olivier Beauchet1, Harmehr Sekhon2, Anne-Marie Schott3, Yves Rolland4, Susan Muir-Hunter5, Maureen Markle-Reid6, Helene Gagne7, Gilles Allali8. 1. Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Dr Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address: olivier.beauchet@mcgill.ca. 2. Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada; Faculty of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada. 3. Université Claude Bernard Lyon 1, HESPER unit EA 7425, Lyon, France; Hospices Civils de Lyon, Pôle de santé publique, Lyon, France. 4. Department of Geriatric, Toulouse University Hospital, Toulouse, France. 5. Lawson Health Research Institute; University of Western Ontario, London, Ontario, Canada; School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada. 6. School of Nursing, McMaster University, Hamilton, Ontario, Canada. 7. Ontario Neurotrauma Foundation, Toronto, Ontario, Canada. 8. Department of Neurology, Geneva University Hospital and University of Geneva, Geneva, Switzerland.
Abstract
OBJECTIVE: Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and its components [ie, slow walking speed and subjective cognitive complaint (SCC)] with the occurrence of falls, their recurrence, and postfall fractures in older community-dwelling adults. DESIGN: Observational prospective and longitudinal cohort study. SETTING AND PARTICIPANTS: French community-dwelling older women (n = 5958) recruited in the EPIDémiologie de l'OStéoporose (EPIDOS) study. MEASURES: MCR was defined as both the presence of SCC and slow walking speed in women free of major neurocognitive disorders. Falls (≥1), recurrent falls (≥2), and postfall fractures (any fractures and hip fractures) were prospectively recorded using mail and/or phone call questionnaires every 4 months over 4 years. RESULTS: At baseline, the prevalence of SCC was 43.1% (n = 2569), slow walking speed 5.7% (n = 341), and MCR 9.9% (n = 591). Overall, 25.7% (n = 1533) of participants reported any fall during the follow-up. The incidence of postfall hip fractures was higher in participants with MCR compared to healthy participants and those with SCC (P ≤ .001). Cox regression models revealed that only participants with MCR had a significantly high risk for falls [hazard ratio (HR) = 1.22, P = .021], recurrent falls (HR = 1.46 with P = .030), and postfall hip fractures (HR = 2.54, P ≤ .001). CONCLUSIONS/IMPLICATIONS: There is an increased risk for falls, their recurrence, and postfall hip fractures associated with MCR but not with its individual components. This finding underscores the clinical interest of MCR for the detection of older adults at risk for falls and their related adverse events in order to start early appropriate interventions for fall reduction.
OBJECTIVE:Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and its components [ie, slow walking speed and subjective cognitive complaint (SCC)] with the occurrence of falls, their recurrence, and postfall fractures in older community-dwelling adults. DESIGN: Observational prospective and longitudinal cohort study. SETTING AND PARTICIPANTS: French community-dwelling older women (n = 5958) recruited in the EPIDémiologie de l'OStéoporose (EPIDOS) study. MEASURES: MCR was defined as both the presence of SCC and slow walking speed in women free of major neurocognitive disorders. Falls (≥1), recurrent falls (≥2), and postfall fractures (any fractures and hip fractures) were prospectively recorded using mail and/or phone call questionnaires every 4 months over 4 years. RESULTS: At baseline, the prevalence of SCC was 43.1% (n = 2569), slow walking speed 5.7% (n = 341), and MCR 9.9% (n = 591). Overall, 25.7% (n = 1533) of participants reported any fall during the follow-up. The incidence of postfall hip fractures was higher in participants with MCR compared to healthy participants and those with SCC (P ≤ .001). Cox regression models revealed that only participants with MCR had a significantly high risk for falls [hazard ratio (HR) = 1.22, P = .021], recurrent falls (HR = 1.46 with P = .030), and postfall hip fractures (HR = 2.54, P ≤ .001). CONCLUSIONS/IMPLICATIONS: There is an increased risk for falls, their recurrence, and postfall hip fractures associated with MCR but not with its individual components. This finding underscores the clinical interest of MCR for the detection of older adults at risk for falls and their related adverse events in order to start early appropriate interventions for fall reduction.
Authors: M Racey; M Markle-Reid; D Fitzpatrick-Lewis; M U Ali; H Gagne; S Hunter; J Ploeg; R Sztramko; L Harrison; R Lewis; M Jovkovic; D Sherifali Journal: BMC Geriatr Date: 2021-12-10 Impact factor: 3.921
Authors: M Racey; M Markle-Reid; D Fitzpatrick-Lewis; M U Ali; H Gagné; S Hunter; J Ploeg; R Sztramko; L Harrison; R Lewis; M Jovkovic; D Sherifali Journal: BMC Geriatr Date: 2021-07-26 Impact factor: 3.921