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J Am Geriatr Soc. 2010 Feb;58(2):338-45. doi: 10.1111/j.1532-5415.2009.02670.x. Epub 2010 Jan 26.

Chronic kidney disease and cognitive function in older adults: findings from the chronic renal insufficiency cohort cognitive study.

Collaborators (158)

Feldman HI, Landis JR, Ballard S, Chen Z, Cifelli D, Curley RM, Dattilo J, Durborow M, Durborow S, Eachus S, Fargo J, Glenn M, Hanish A, Helker C, Herlim M, Anderson AH, Joffe M, Kim H, Kimmel SE, Kumanyika S, Mohler ER 3rd, Nessel L, Parikh G, Praestgard A, Robinson N, Rosen L, Schwartz JS, Smith S, Stahl J, Teal VL, Xie D, Yang P, Townsend RR, Capolla T, Cohen D, Cuevas M, Duckworth MJ, Ford V, Gorman CM, Grunwald J, Kibe L, Leonard MB, Maguire M, McDowell S, Murphy J, Reilly M, Rosas SE, Seamon WM, Sheridan A, Teff K, Appel LJ, Anderson C, Astor B, Charleston J, Jaar B, Miller EP, Ngoh P, Venkatesh H, Young JH, Fink J, Fink W, Parsa A, Scism B, Seliger S, Weir M, Rahman M, Brooks R, Corrigan V, Kisin G, Kanthety R, Strauss L, Wright JT Jr, Schelling J, Kao P, Horowitz E, Bjaloncik J, Fallon T, Sedor JR, Shella MA, Theurer J, Thornton JD, Schreiber MJ, Coleman M, Fatica R, Frey D, Greenwald D, Halliburton S, Horner C, Markle T, Pangonis S, Paradis C, Rafey MA, Russo A, Slattery S, Soos J, Spirko R, Stelmach K, Stephens V, Ojo A, Attili A, Briesmiester J, Corbin TL, Cornish-Zirker D, Gadegbeku C, Hill N, Jamerson K, Whelton P, Go AS, Ackerson LM, Dorin P, Fernandez D, Fox R, Jensvold NG, Lo JC, Ordonez JD, Perloff R, Tan T, Thompson D, Valladares GM, Wiggins A, Wong DB, Yang JM, Hsu CY, Chertow GM, Bansal N, Gorodetskaya I, Grubbs V, Kurella M, Lo L, Shlipak MG, Yaffe K, Kusek JW, Narva AS, Faber-Langendoen K, Kiberd BA, Lee ET, Lewis J, McClellan W, Meyer T, Nathan D, Stokes JB, Taylor H, Wilson PW, Raj D, Shah V, Ridker PM, Rader DJ, DiFlorio A, Mifflin T, Morrell L, Wolfe ML, Hall P, Saunders S, Budoff M, Dailing C, Prineas R, Soliman E, Zhang ZM.

Author information

  • 1Department of Psychiatry, School of Medicine, University of California at San Francisco, San Francisco, California, USA. kristine.yaffe@ucsf.edu

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 m(2)) 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 < or =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.

PMID:
20374407
[PubMed - indexed for MEDLINE]
PMCID:
PMC2852884
Free PMC Article
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