Motoric cognitive risk syndrome among community-dwelling older adults in China: Prevalence, associated factors, and adverse outcomes

Introduction: Motoric cognitive risk syndrome (MCR) is a screening syndrome that has been associated with increased dementia risk in prior studies. This study aimed to investigate the prevalence, associated factors, and adverse outcomes of MCR among community-dwelling older adults in China. Methods: A cross-sectional analysis was conducted among 5,242 CHARLS participants aged ≥60 years to examine factors associated with prevalent MCR, and prospective outcomes were evaluated over a 3-year follow-up. The Boruta algorithm was used for feature selection. Multivariate logistic regression analysis was employed to assess associations, while XGBoost was applied as a complementary baseline classification approach to rank feature importance for distinguishing prevalent MCR. Results: The prevalence of MCR was 12.9% among the study population, with higher rates in unmarried, illiterate, and older participants. Physical performance measures emerged as the strongest associated factors, with five-time sit-to-stand test (OR=1.05, 95%CI: 1.03-1.07), handgrip strength (OR=0.98, 95%CI: 0.97-0.99), and mobility score (OR=1.12, 95%CI: 1.04-1.19) showing significant associations. Higher education level (OR=0.67, 95%CI: 0.51-0.89) and social activity participation (OR=0.69, 95%CI: 0.58-0.82) were inversely associated with prevalent MCR, while stroke (OR=2.18, 95%CI: 1.43-3.24), visual impairment (OR=1.40, 95%CI: 1.08-1.84), and poor self-reported health status (OR=1.50, 95%CI: 1.13-2.00) were associated with higher odds of prevalent MCR. MCR was prospectively associated with ADL disability (adjusted OR=1.40, 95% CI: 1.12–1.73) but not hospitalization (adjusted OR=1.08, 95% CI: 0.87–1.34). Conclusion: These findings underscore the importance of incorporating physical performance measures and social factors in MCR screening protocols and may inform screening and risk stratification in aging populations.