association of motoric cognitive risk ......association of motoric cognitive risk syndrome with...

ASSOCIATION OF MOTORIC COGNITIVE RISK SYNDROME WITH CARDIOVASCULAR DISEASES AND RISK FACTORS

Harmehr SEKHON, Cyrille LAUNAY, Gilles ALLALI,Julia CHABOT, Olivier BEAUCHET

CANADIAN GERIATRICS SOCIETY – 38TH ANNUAL SCIENTIFIC MEETING – APRIL 20-21, 2018

PRESENTER DISCLOSURES

Presenter: Harmehr SEKHON

Relationship with financial sponsors: None

Discussion of Off-Label, Investigational, or Experimental Drug Use: No

This program has received financial support from None

This program has received in-kind support from None

Potential for conflict of interest No

ASSOCIATION OF MOTORIC COGNITIVE RISK SYNDROME WITH CARDIOVASCULAR RISK FACTORS

NEED FOR IMPROVING DEMENTIA SCREENING_

Dementia is a major public health issue (high incidence and adverse consequences).

Past decade characterized by increased interest in identifying and validating biomarkers for early diagnosis of dementia

Need to optimize global accessibility of clinical dementia risk assessments (e.g., screening) in community-dwelling populations, in order to initiate effective preventive measures.

BACKGROUND


MOTORIC COGNITIVE RISK SYNDROME_

New clinical syndrome combining:

Subjective cognitive impairment: Perceived changes in cognition in the absence of objective evidence.

Slow gait speed: Gait speed one SD or more below age-and sex-appropriate mean values established in the present cohort.

Pre-dementia stage

BACKGROUND


ASSOCIATION OF MCR WITH CARDIOVASCULAR DISEASES AND RISK FACTORS IS STILLA MATTER OF DEBATE_

MCR predicts both Alzheimer Disease (AD) and Vascular Dementia (VaD), but the strength of association between MCR and VaD is stronger than AD, suggesting a link with Cardiovascular Diseases and Risk Factors (CVDRF).

CVDRF (e.g., high blood pressure, obesity and diabetes) may cause VaD.

Mixed results about the association of MCR syndrome with CVDRF related to populations.

BACKGROUND


ASSOCIATION OF MCR WITH CARDIOVASCULAR DISEASES AND RISK FACTORS IS STILLA MATTER OF DEBATE_

To date, no systematic critical evaluation of studies with the purpose of examining the association of MCR syndrome with CVDRF has been performed.

Demonstrating that CVDRF were effectively associated with MCR syndrome, regardless of the origin of the populations, could be helpful to develop common global strategies for preventive measures for older individuals at risk for dementia.

BACKGROUND


HYPOTHESIS AND OBJECTIVE_

Hypothesis: The profile of associated CVDRF could change across various populations.

Objective: To quantitatively synthesize, with a systematic review and meta-analysis, the association of MCR with CVDRF.

BACKGROUND


DESIGN, SETTING AND POPULATION_

Systematic review and meta-analysis

Medline (Pubmed) and EMBASE (Ovid, EMBASE) in February 2017

Search terms: “motoric cognitive risk syndrome” or “motoric risk” or“motoric cognitive risk”

The selection criteria for the article: human studies, articles in English and French, original study with peer-reviewed publications in indexed scientific journals, MCR syndrome and CVDRF as outcomes, two groups of participants including MCR and non-MCR syndrome individuals

Cardiovascular risk factors examined: Cardiovascular diseases, hypertension, diabetes, stroke and obesity

METHODS


METHODS


5.9%

RESULTS


OR

> SIGNIFICANT ASSOCIATION

CARDIOVASCULAR DISEASES


OR

> SIGNIFICANT ASSOCIATION BUT DIVERGENCES BETWEEN STUDIES

RESULTS HYPERTENSION


OR

> NO SIGNIFICANT ASSOCIATION IN INDIAN POPULATION

RESULTS DIABETES


OR

> SIGNIFICANT ASSOCIATION BUT FEW STUDIES

RESULTS STROKE


OR

SIGNIFICANT ASSOCIATION BUT HETEROGENOUS NUMBEROF INDIVIDUALS BETWEEN STUDIES

RESULTS OBESITY

GLOBAL RESULTS


OR

MCR IS ASSOCIATED WITH CVDRF BUT…_

Significant association of MCR with CVDRF: Adverse consequences of CVDRF like cerebrovascular lesions and brain atrophy can both lead to memory complaint and slow gait speed.

The type of CVDRF associated with MCR changed across the studied populations:

_ Lowest Odd Ratio being reported for hypertension and the highest for stroke, the magnitude of variation ranging from 1.21 to 2.05_ No significant association was reported in the Indian population, whereas it was present for American, Japanese and French populations.

DISCUSSION AND CONCLUSION


MCR IS ASSOCIATED WITH CVDRF BUT…_

Together, these results suggest that factors such as ethnicity, environment and lifestyle may influence the association among populations.

However, the meta-analysis indicates the presence of a robust and systematic significant association, regardless of the type of CVDRF (OR=1.38).

Main limitations: _Limited number of studies_Heterogenous number of participants between studies_Variation in the definition of CVDRF across studies

DISCUSSION AND CONCLUSION


MCR IS ASSOCIATED WITH CVDRF… AND SO WHAT?_

These findings may help to elucidate the pathophysiological mechanisms explaining MCR syndrome and its association with the occurrence of dementia.

What about Canadian population? _ Canadian Longitudinal Study of Aging

What is expected?_ Better care continuum_ Decreased incidence of dementia and adverse consequences

PERSPECTIVES


THANK YOU!_

Questions?

CANADIAN GERIATRICS SOCIETY – 38TH ANNUAL SCIENTIFIC MEETING – APRIL 20-21, 2018

[email protected]

association of motoric cognitive risk ......association of motoric cognitive risk syndrome with...

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