Motoric Cognitive Risk Syndrome: Prevalence and Risk of Cognitive Impairment in a Population Studied in the Mexican Health and Aging Study 2012-2015.

OBJECTIVES: The aim of this study was to determine the prevalence of Motoric Cognitive Risk (MCR) syndrome, describe associated risk factors and to determine the risk of progression to cognitive impairment after three years of follow-up, in a sample of Mexican older adults. DESIGN: A prospective panel study of health and aging in Mexico. SETTING AND PARTICIPANTS: Baseline and follow-up information was obtained from the Mexican Health and Aging Study's 2012 and 2015 waves. A total of 726 subjects aged 60 years or older with normal cognition at baseline were classified into 4 groups: 1) with MCR, 2) with memory complaint only, 3) with slow gait speed only and, 4) without MCR. Cox regression analysis controlling for confounder factors was performed to determine the risk of progression to cognitive impairment in the MCR group. MEASURES: Data such as gait speed, functional status and cognitive performance (standardized by age and sex in Mexican population) was collected. RESULTS: MCR prevalence was 14.3%. When compared with non-MCR subjects, the presence of MCR was associated with older age (p<0.01), lower educational status (p=0.05), having two or more comorbidities (p<0.05) and diabetes mellitus diagnosis (p<0.05). At follow-up and after adjusting for confounders, MCR was associated with a 2.4-fold increased risk (95% CI: 1.28-4.26, p=.000) of cognitive impairment. CONCLUSIONS: MCR syndrome increases the risk of cognitive impairment in Mexican older adults. Simple measurements such as gait evaluation in subjects with memory complaints could allow early identification of those at risk of developing cognitive impairment.

Diabetes mellitus como factor de riesgo de demencia en la población adulta mayor mexicana / Diabetes mellitus as a risk factor for dementia in the Mexican elder population

Introducción. La diabetes mellitus y las demencias constituyen dos problemas crecientes de salud entre la población adulta mayor del mundo y, en particular, de los países en desarrollo. Hacen falta estudios longitudinales sobre el papel de la diabetes como factor de riesgo de demencia. Objetivo. Determinar el riesgo de demencia en sujetos mexicanos con diabetes mellitus tipo 2. Pacientes y métodos. Los sujetos diabéticos libres de demencia pertenecientes al Estudio Nacional de Salud y Envejecimiento en México fueron evaluados a los dos años de la línea de base. Se estudió el papel de los factores sociodemográficos, de otras comorbilidades y del tipo de tratamiento en la conversión a demencia. Resultados. Antes de iniciar el estudio, 749 sujetos (13,8%) padecían diabetes. El riesgo de desarrollar demencia en estos individuos fue el doble (riesgo relativo, RR = 2,08; intervalo de confianza del 95%, IC 95% = 1,59-2,73). Se encontró un riesgo mayor en individuos de 80 años y más (RR = 2,44; IC 95% = 1,46-4,08), en los hombres (RR = 2,25; IC 95% = 1,46- 3,49) y en sujetos con nivel educativo inferior a siete años. El estar bajo tratamiento con insulina incrementó el riesgo de demencia (RR = 2,83; IC 95% = 1,58-5,06). Las otras comorbilidades que aumentaron el riesgo de demencia en los pacientes diabéticos fueron la hipertensión (RR = 2,75; IC 95% = 1,86-4,06) y la depresión (RR = 3,78; IC 95% = 2,37-6,04). Conclusión. Los sujetos con diabetes mellitus tienen un riesgo mayor de desarrollar demencia. La baja escolaridad y otras comorbilidades altamente prevalentes en la población mexicana contribuyen a la asociación diabetes-demencia (AU)

Introduction. Diabetes and dementia are growing problems throughout the world and especially in developing countries. Aim. To determine the risk of developing dementia in subjects with type 2 diabetes mellitus. Patients and methods. Diabetic elders free of dementia from the Mexican Health and Aging study, a prospective communitybased cohort research were followed after two years. Socio-demographic factors, comorbid conditions and type of diabetes treatment were analyzed in subjects who become demented. Results. At baseline, 749 participants (13.8%) had diabetes mellitus. During the follow-up period (mean: 2.02 years; range: 1-3 years), 306 of 749 persons with diabetes mellitus developed dementia, yielding a relative risk (RR) of 2.08 (95% confidence interval, 95% CI = 1.59-2.73). The effect was strongest in persons aged 80 years or older with a RR of 2.44 (95% CI = 1.46-4.08), men had a greater relative risk than women (RR = 2.25; 95% CI = 1.46-3.49 vs. RR = 1.98; 95% CI = 1.08-1.11) and subjects with low education (< 7 years of schooling) had a significant RR while those with higher education didn’t. Individuals treated with insulin where at highest risk of dementia (RR = 2.83; 95% CI = 1.58-5.06). Hypertension (RR = 2.75; 95% CI = 1.86-4.06) and depression (RR = 3.78; 95% CI = 2.37-6.04) where the two comorbidities which increased the risk of dementia. Conclusions. Subjects with diabetes mellitus have an increased risk of developing dementia. Sociodemographic factors and other comorbidities highly prevalent in the Mexican population contribute to the diabetes-dementia association (AU)