Motor function and incident dementia: a systematic review and meta-analysis.
Backgroundcognitive and mobility decline are interrelated processes, whereby mobility decline coincides or precedes the onset of cognitive decline.
Objectiveto assess whether there is an association between performance on motor function tests and incident dementia.
Methodselectronic database, grey literature and hand searching identified studies testing for associations between baseline motor function and incident dementia in older adults.
Resultsof 2,540 potentially relevant documents, 37 met the final inclusion criteria and were reviewed qualitatively. Three meta-analyses were conducted using data from 10 studies. Three main motor domains-upper limb motor function, parkinsonism and lower limb motor function-emerged as associated with increased risk of incident dementia. Studies including older adults without neurological overt disease found a higher risk of incident dementia associated with poorer performance on composite motor function scores, balance and gait velocity (meta-analysis pooled HR = 1.94, 95% CI: 1.41, 2.65). Mixed results were found across different study samples for upper limb motor function, overall parkinsonism (meta-analysis pooled OR = 3.05, 95% CI: 1.31, 7.08), bradykinesia and rigidity. Studies restricted to older adults with Parkinson's Disease found weak or no association with incident dementia even for motor domains highly associated in less restrictive samples. Tremor was not associated with an increased risk of dementia in any population (meta-analysis pooled HR = 0.80, 95% CI 0.31, 2.03).
Conclusionlower limb motor function was associated with increased risk of developing dementia, while tremor and hand grip strength were not. Our results support future research investigating the inclusion of quantitative motor assessment, specifically gait velocity tests, for clinical dementia risk evaluation.
The University of Western Ontario-Schulich School of Medicine and Dentistry, Department of Epidemiology and Biostatistics, London, Ontario, Canada.,
The University of Western Ontario - Schulich School of Medicine and Dentistry, Department of Epidemiology and Biostatistics, London, Ontario, Canada. The University of Western Ontario - Schulich Interfaculty Program in Public Health, London, Ontario, Canada.,
The University of Western Ontario-School of Kinesiology, Faculty of Health Sciences, London, Ontario, Canada.
The University of Western Ontario - Schulich School of Medicine and Dentistry, Department of Epidemiology and Biostatistics, London, Ontario, Canada. The University of Western Ontario - School of Kinesiology, Faculty of Health Sciences, London, Ontario, Canada. The University of Western Ontario - Schulich Faculty of Medicine and Dentistry, Department of Medicine, Division of Geriatric Medicine, London, Ontario, Canada. Lawson Health Research Institute, Gait and Brain Lab, Parkwood Institute, London, Canada.
Aged, 80 and over
Pub Type(s)Journal Article