PhilippMahlknecht, Resident, Innsbruck Medical UniversityKlaus.Seppi@uki.at
Stefan Kiechl, Innsbruck, Austria; Johann Willeit, Innsbruck, Austria; Werner Poewe, Innsbruck, Austria; and Klaus Seppi, Innsbruck, Austria
Submitted December 30, 2014
Verghese et al. described motoric cognitive risk syndrome (MCR), a pre-dementia syndrome characterized by slow gait and cognitive complaints. [1] Strokes, Parkinson disease, depressive symptoms, sedentariness, and obesity predicted incident MCR. [1] As hyposmia may accompany Alzheimer dementia [2,3] and precede incident gait disturbances, [4] we hypothesized that hyposmia could be a risk factor for MCR. Participants from the population-based Bruneck study-- representative of the general elderly white community-- underwent a baseline and 5- year follow-up neurological examination including a gait speed assessment. [4,5] We assessed baseline olfactory function and vascular risk using the Sniffin' Sticks odor-identification test and Framingham risk score. [4] MCR was defined exactly as reported by Verghese et al. [1] Subjects with dementia or immobility at baseline or follow-up and subjects with MCR at baseline were excluded. Of 464 eligible subjects (age at baseline, mean+/-SD: 67.5+/-8.3 years, range: 54.9-90.0 years; 53.0% females), 103 (22.2%) present with MCR at follow-up. A logistic regression analysis adjusted for age and sex revealed an odds ratio for incident MCR of 2.56 (95%CI, 1.46-4.36) for hyposmia and 2.03 (95%CI, 1.03-3.99) for high vascular risk. Our results suggest that hyposmia is associated with an increased risk of developing MCR and, as expected, an increased vascular risk.
1. Verghese J, Ayers E, Barzilai N, et al. Motoric cognitive risk syndrome: Multicenter incidence study. Neurology 2014; 83: 2278-2284.
2. Wilson R, Arnold SE, Schneider JA, Tang Y, Bennett DA. The relationship between cerebral Alzheimer's disease pathology and odour identification in old age. J Neurol Neurosurg Psychiatry 2007;78:30-35.
3. Doty RL, Perl DP, Steele JC, et al. Odor identification deficit of the parkinsonism-dementia complex of Guam: equivalence to that of Alzheimer's and idiopathic Parkinson's disease. Neurology 1991;41(5 Suppl 2):77-81.
4. Mahlknecht P, Kiechl S, Stockner H, et al. Predictors for incident mild parkinsonian signs: A prospective population-based study. Parkinsonism Relat Disord. In press. DOI: http://dx.doi.org/10.1016/j.parkreldis.2014.12.021.
5. Mahlknecht P, Kiechl S, Bloem BR, et al. Prevalence and burden of gait disorders in elderly men and women aged 60-97 years: a population-based study. PLoS One. 2013;24:e69627.
For disclosures, please contact the editorial office at journal@neurology.org.
Verghese et al. described motoric cognitive risk syndrome (MCR), a pre-dementia syndrome characterized by slow gait and cognitive complaints. [1] Strokes, Parkinson disease, depressive symptoms, sedentariness, and obesity predicted incident MCR. [1] As hyposmia may accompany Alzheimer dementia [2,3] and precede incident gait disturbances, [4] we hypothesized that hyposmia could be a risk factor for MCR. Participants from the population-based Bruneck study-- representative of the general elderly white community-- underwent a baseline and 5- year follow-up neurological examination including a gait speed assessment. [4,5] We assessed baseline olfactory function and vascular risk using the Sniffin' Sticks odor-identification test and Framingham risk score. [4] MCR was defined exactly as reported by Verghese et al. [1] Subjects with dementia or immobility at baseline or follow-up and subjects with MCR at baseline were excluded. Of 464 eligible subjects (age at baseline, mean+/-SD: 67.5+/-8.3 years, range: 54.9-90.0 years; 53.0% females), 103 (22.2%) present with MCR at follow-up. A logistic regression analysis adjusted for age and sex revealed an odds ratio for incident MCR of 2.56 (95%CI, 1.46-4.36) for hyposmia and 2.03 (95%CI, 1.03-3.99) for high vascular risk. Our results suggest that hyposmia is associated with an increased risk of developing MCR and, as expected, an increased vascular risk.
1. Verghese J, Ayers E, Barzilai N, et al. Motoric cognitive risk syndrome: Multicenter incidence study. Neurology 2014; 83: 2278-2284.
2. Wilson R, Arnold SE, Schneider JA, Tang Y, Bennett DA. The relationship between cerebral Alzheimer's disease pathology and odour identification in old age. J Neurol Neurosurg Psychiatry 2007;78:30-35.
3. Doty RL, Perl DP, Steele JC, et al. Odor identification deficit of the parkinsonism-dementia complex of Guam: equivalence to that of Alzheimer's and idiopathic Parkinson's disease. Neurology 1991;41(5 Suppl 2):77-81.
4. Mahlknecht P, Kiechl S, Stockner H, et al. Predictors for incident mild parkinsonian signs: A prospective population-based study. Parkinsonism Relat Disord. In press. DOI: http://dx.doi.org/10.1016/j.parkreldis.2014.12.021.
5. Mahlknecht P, Kiechl S, Bloem BR, et al. Prevalence and burden of gait disorders in elderly men and women aged 60-97 years: a population-based study. PLoS One. 2013;24:e69627.
For disclosures, please contact the editorial office at journal@neurology.org.