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Background <p>Motoric cognitive risk syndrome (MCR), defined by the presence of subjective cognitive complaints and slow gait in the absence of dementia, is a critical pre-dementia state. However, management strategies for MCR remain fragmented. The Proactive Health Management (PHM) framework, which emphasizes integrated, preventive care, offers a potential framework for coordinating MCR management. Therefore, this scoping review aimed to systematically map and synthesize the existing evidence on MCR management strategies within the PHM framework.</p> Methods <p>Following Joanna Briggs Institute guidelines and PRISMA-ScR reporting standards, we searched eight databases (PubMed, Web of Science, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, and Weipu) for studies published between 2013 and April 2025. Studies involving older adults (≥ 60 years) with MCR addressing at least one of the five PHM dimensions were included. Data were extracted and synthesized narratively according to the PHM framework.</p> Results <p>Seventeen studies were included. The distribution of evidence across PHM dimensions was markedly uneven. Most research focused on accurate health risk prediction (<i>n</i> = 8, 47.1%) and effective interventions on health outcomes (<i>n</i> = 6, 35.3%). Health literacy enhancement was addressed by only one study (5.9%), and intelligent warning systems were explored in two studies (11.8%). No studies explicitly targeted comprehensive health promotion as a primary outcome. MCR was associated with an increased risk of incident dementia, mortality, and functional decline. Cognitive training, physical exercise, and combined interventions may be associated with short-term improvements in specific cognitive and physical domains. A key finding was the substantial heterogeneity in the operationalization of MCR, particularly in the assessment methods for its core components.</p> Conclusions <p>Current research on MCR management is in its early stages and does not fully align with the integrated, proactive principles of the PHM framework. The evidence base is dominated by risk stratification and preliminary intervention studies, while foundational areas like health literacy and technological monitoring are less developed. Future work could focus on standardizing MCR assessment, addressing key gaps in the underrepresented PHM dimensions, and developing and testing integrated management models to enable proactive, person-centered care for this high-risk population.</p>

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Proactive health management strategies for older adults with motoric cognitive risk syndrome: a scoping review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Xuting Chang,
  • Yunhao Zhang,
  • Mengrou Liu,
  • Ting Wang,
  • Haixia Wang

摘要

Background

Motoric cognitive risk syndrome (MCR), defined by the presence of subjective cognitive complaints and slow gait in the absence of dementia, is a critical pre-dementia state. However, management strategies for MCR remain fragmented. The Proactive Health Management (PHM) framework, which emphasizes integrated, preventive care, offers a potential framework for coordinating MCR management. Therefore, this scoping review aimed to systematically map and synthesize the existing evidence on MCR management strategies within the PHM framework.

Methods

Following Joanna Briggs Institute guidelines and PRISMA-ScR reporting standards, we searched eight databases (PubMed, Web of Science, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, and Weipu) for studies published between 2013 and April 2025. Studies involving older adults (≥ 60 years) with MCR addressing at least one of the five PHM dimensions were included. Data were extracted and synthesized narratively according to the PHM framework.

Results

Seventeen studies were included. The distribution of evidence across PHM dimensions was markedly uneven. Most research focused on accurate health risk prediction (n = 8, 47.1%) and effective interventions on health outcomes (n = 6, 35.3%). Health literacy enhancement was addressed by only one study (5.9%), and intelligent warning systems were explored in two studies (11.8%). No studies explicitly targeted comprehensive health promotion as a primary outcome. MCR was associated with an increased risk of incident dementia, mortality, and functional decline. Cognitive training, physical exercise, and combined interventions may be associated with short-term improvements in specific cognitive and physical domains. A key finding was the substantial heterogeneity in the operationalization of MCR, particularly in the assessment methods for its core components.

Conclusions

Current research on MCR management is in its early stages and does not fully align with the integrated, proactive principles of the PHM framework. The evidence base is dominated by risk stratification and preliminary intervention studies, while foundational areas like health literacy and technological monitoring are less developed. Future work could focus on standardizing MCR assessment, addressing key gaps in the underrepresented PHM dimensions, and developing and testing integrated management models to enable proactive, person-centered care for this high-risk population.