Abstract
BackgroundCognitive decline is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly population. We conducted this study to clarify the relationship between renal dysfunction and decline of cognitive function in community-dwelling elderly population.MethodsA cross-sectional analysis was performed using data from the Korean Frailty and Aging Cohort Study, a nationwide cohort study. Total 2847 (1333 men, 1514 women) eligible participants were enrolled for this study. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Global cognitive function was assessed with the Mini-mental State Examination-Korean version. Other domains of cognitive function were tested with the Consortium to Establish a Registry for Alzheimer’s disease and the Frontal Assessment Battery.ResultsThe mean age of all participants was 76.0 ± 3.9 years and eGFR (all in mL/min/1.73 m2) was 77.5 ± 14.3. And the mean eGFR was 91.7 ± 3.2 in quartile 1, 84.9 ± 1.8 in quartile 2, 76.1 ± 3.7 in quartile 3, and 57.2 ± 10.8 in quartile 4. In baseline characteristics, participants with lower eGFR tend to have lower cognitive function scores than participant with higher eGFR. In linear regression analysis, eGFR was correlated with the word list memory (β = 0.53, P = 0.005), word list recall (β = 0.86, P < 0.001), and word list recognition (β = 0.43, P = 0.030) after adjustment of confounding variables. Moreover, after multivariate adjustment the association with cognitive impairment in quartile 2 was stronger (adjusted OR: 1.535, 95% CI: 1.111–2.120, P = 0.009), and the ORs of cognitive impairment were 1.501 (95% CI: 1.084–2.079, P = 0.014) in quartile 3 and 1.423 (95% CI: 1.022–1.983, P = 0.037) in quartile 4.ConclusionIn older adults, the immediate, recent memory, and recognition domains were significantly related to renal function. Also, the mild renal dysfunction was independently associated with impairment of global cognitive function. These results suggest that the early stages of renal dysfunction could be an effective target to prevent worsening of cognitive impairment. Therefore, regular monitoring and early detection of mild renal dysfunction in elderly population might be needed.
Highlights
Cognitive decline is common in older adults
The Odds ratio (OR) of global cognitive impairment were 1.501 in quartile 3 and 1.423 in quartile 4. In this cross-sectional study, we showed the association between renal function and neurocognitive function in older adults
The main results were as follows: (1) the immediate, recent memory, and recognition function domains were independently associated with estimated glomerular filtration rate (eGFR), (2) in women, the memory domains were significantly associated with eGFR, and (3) mild decline of
Summary
Cognitive decline is common in older adults. The prevalence of renal dysfunction is increased in the elderly population. We conducted this study to clarify the relationship between renal dysfunction and decline of cognitive function in community-dwelling elderly population. The prevalence of cognitive impairment and dementia, which can increase the social and economic burden and reduce the quality of life, is higher in the elderly population [3, 4]. Patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) on hemodialysis have a high risk of cognitive impairment [5, 6]. In prior studies of the elderly populations, CKD was found to increase the incidence of cognitive impairment and vascular dementia [10,11,12,13,14,15]. Cognitive decline was found to be more rapid in patients with CKD [16]
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