Chronic Kidney Disease and Cognitive Function in Older Adults: Findings from the Chronic Renal Insufficiency Cohort Cognitive Study
Open Access
- 27 January 2010
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 58 (2), 338-345
- https://doi.org/10.1111/j.1532-5415.2009.02670.x
Abstract
OBJECTIVES: To investigate cognitive impairment in older, ethnically diverse individuals with a broad range of kidney function, to evaluate a spectrum of cognitive domains, and to determine whether the relationship between chronic kidney disease (CKD) and cognitive function is independent of demographic and clinical factors. DESIGN: Cross‐sectional. SETTING: Chronic Renal Insufficiency Cohort Study. PARTICIPANTS: Eight hundred twenty‐five adults aged 55 and older with CKD. MEASUREMENTS: Estimated glomerular filtration rate (eGFR, mL/min per 1.73 m2) was estimated using the four‐variable Modification of Diet in Renal Disease equation. Cognitive scores on six cognitive tests were compared across eGFR strata using linear regression; multivariable logistic regression was used to examine level of CKD and clinically significant cognitive impairment (score ≤1 standard deviations from the mean). RESULTS: Mean age of the participants was 64.9, 50.4% were male, and 44.5% were black. After multivariable adjustment, participants with lower eGFR had lower cognitive scores on most cognitive domains (P<.05). In addition, participants with advanced CKD (eGFR<30) were more likely to have clinically significant cognitive impairment on global cognition (adjusted odds ratio (AOR) 2.0, 95% CI=1.1–3.9), naming (AOR=1.9, 95% CI=1.0–3.3), attention (AOR=2.4, 95% CI=1.3–4.5), executive function (AOR=2.5, 95% CI=1.9–4.4), and delayed memory (AOR=1.5, 95% CI=0.9–2.6) but not on category fluency (AOR=1.1, 95% CI=0.6–2.0) than those with mild to moderate CKD (eGFR 45–59). CONCLUSION: In older adults with CKD, lower level of kidney function was associated with lower cognitive function on most domains. These results suggest that older patients with advanced CKD should be screened for cognitive impairment.Keywords
This publication has 35 references indexed in Scilit:
- Chronic kidney disease, creatinine and cognitive functioningNephrology Dialysis Transplantation, 2009
- Kidney Function and Cognitive Performance and Decline in Older MenJournal of the American Geriatrics Society, 2008
- Kidney Function and Cognitive Impairment in US Adults: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) StudyAmerican Journal of Kidney Diseases, 2008
- Cystatin C as a marker of cognitive function in elders: Findings from the health ABC studyAnnals of Neurology, 2008
- Prevalence of Dementia in the United States: The Aging, Demographics, and Memory StudyNeuroepidemiology, 2007
- Black and White Differences in Cognitive Function Test Scores: What Explains the Difference?Journal of the American Geriatrics Society, 2004
- Chronic kidney disease, anemia, and incident stroke in a middle-aged, community-based population: The ARIC StudyKidney International, 2003
- Elevated risk of stroke among patients with end-stage renal diseaseKidney International, 2003
- The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological batteryNeurology, 1994
- Predicting development of dementia in the elderly with the Selective Reminding TestJournal of Clinical and Experimental Neuropsychology, 1990