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Journal of the American Geriatrics Society
Nov, 2008;56 (11): 2082-8.

Kidney function and cognitive performance and decline in older men.

Yelena Slinin, Misti L Paudel, Areef Ishani, Brent C Taylor, Kristine Yaffe, Anne M Murray, Howard A Fink, Eric S Orwoll, Steven R Cummings, Elizabeth Barrett-Connor, Simerjot Jassal, Kristine E Ensrud, Osteoporotic Fractures in Men Study Group
Author Information
  1. Yelena Slinin: Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota, USA. slini001@umn.edu
PMID: 18795984 DOI: 10.1111/j.1532-5415.2008.01936.x

Abstract

OBJECTIVES: To examine the association between kidney function and cognitive impairment and decline in elderly men.
DESIGN: Observational prospective cohort.
SETTING: Community based.
PARTICIPANTS: Five thousand five hundred twenty-nine community dwelling men aged 65 and older (mean age 73.6 +/- 5.9).
MEASUREMENTS: Estimated glomerular filtration rate (eGFR) calculated using the standardized Modification of Diet in Renal Disease (MDRD) equation; cognitive function assessed using the Modified Mini-Mental State Examination (3MS) and Trail Making Test B (Trails B).
RESULTS: At baseline, 148 (2.7%) and 494 (9.1%) men were classified as cognitively impaired and, in the 5-year prospective analysis, 931 (23%) and 432 (11.6%) met the criteria for cognitive decline at follow-up defined according to 3MS and Trails B performance, respectively. In unadjusted analysis, the odds of prevalent cognitive impairment and risk of cognitive decline were significantly higher in men with an eGFR less than 45 and 45 to 59 mL/min per 1.73 m(2) than in men with an eGFR 60 mL/min per 1.73 m(2) or greater. Differences in age, race, and education between eGFR categories largely explained these associations, with the exception of the association between poorer renal function and higher odds of impairment based on Trails B test score, which persisted despite adjustment for multiple potential confounders.
CONCLUSION: This study found evidence of an independent association between mild to moderate reductions in kidney function and poor executive function at baseline but not with global cognitive impairment or risk of cognitive decline in older men.

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Grants

  1. U01 AR45632/NIAMS NIH HHS
  2. AG027810/NIA NIH HHS
  3. AR45614/NIAMS NIH HHS
  4. AR45580/NIAMS NIH HHS
  5. U01 AR45614/NIAMS NIH HHS
  6. U01 AR045654/NIAMS NIH HHS
  7. U01-AG027810/NIA NIH HHS
  8. U01 AR045583/NIAMS NIH HHS
  9. U01 AG042140/NIA NIH HHS
  10. AR45632/NIAMS NIH HHS
  11. AR45583/NIAMS NIH HHS
  12. U01 AR45647/NIAMS NIH HHS
  13. AR45654/NIAMS NIH HHS
  14. AR45647/NIAMS NIH HHS
  15. U01 AR045614/NIAMS NIH HHS
  16. U01 AR45654/NIAMS NIH HHS
  17. U01 AR45583/NIAMS NIH HHS
  18. RR024140/NCRR NIH HHS
  19. U01 AR045580-01/NIAMS NIH HHS
  20. U01 AR045647/NIAMS NIH HHS
  21. U01 AR45580/NIAMS NIH HHS
  22. U01 AG027810/NIA NIH HHS
  23. AG18197/NIA NIH HHS
  24. UL1 RR024140/NCRR NIH HHS
  25. U01 AR045580/NIAMS NIH HHS
  26. U01 AG18197/NIA NIH HHS
  27. U01 AG018197/NIA NIH HHS
  28. U01 AR066160/NIAMS NIH HHS
  29. U01 AR045632/NIAMS NIH HHS

MeSH Term

Age Factors
Aged
Aged, 80 and over
Cognition Disorders
Cohort Studies
Cross-Sectional Studies
Glomerular Filtration Rate
Humans
Male
Odds Ratio
Prevalence
Renal Insufficiency, Chronic
Risk Factors
Journal Article Research Support, N.I.H., Extramural

Word Cloud

Created with Highcharts 10.0.0cognitivemenfunctiondeclineimpairmenteGFRBassociationolder73Trails2kidneyprospectivebasedage9using3MSbaselineanalysisperformanceoddsriskhigher45mL/minper1mOBJECTIVES:examineelderlyDESIGN:ObservationalcohortSETTING:CommunityPARTICIPANTS:Fivethousandfivehundredtwenty-ninecommunitydwellingaged65mean6+/-5MEASUREMENTS:EstimatedglomerularfiltrationratecalculatedstandardizedModificationDietRenalDiseaseMDRDequationassessedModifiedMini-MentalStateExaminationTrailMakingTestRESULTS:1487%4941%classifiedcognitivelyimpaired5-year93123%432116%metcriteriafollow-updefinedaccordingrespectivelyunadjustedprevalentsignificantlyless5960greaterDifferencesraceeducationcategorieslargelyexplainedassociationsexceptionpoorerrenaltestscorepersisteddespiteadjustmentmultiplepotentialconfoundersCONCLUSION:studyfoundevidenceindependentmildmoderatereductionspoorexecutiveglobalKidney

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