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Geriatr Gerontol Int. 2017 Nov;17(11):1899-1906. doi: 10.1111/ggi.12985. Epub 2017 Feb 22.

Renal function affects hippocampal volume and cognition: The role of vascular burden and amyloid deposition.

Author information

1
National Institute of Dementia, Seongnam, South Korea.
2
Department of Psychiatry, Seoul National, University Bundang Hospital, Seongnam, South Korea.
3
Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
4
Department of Psychiatry, Ajou University Hospital, Ajou University, School of Medicine, Suwon, South Korea.
5
Department of Biostatistics, Korea University Graduate School, Seoul, South Korea.
6
Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
7
Clinical Neuroscience Lab, Department of Psychology, Seoul National University, Seoul, South Korea.
8
Division of Nephrology, Department of Internal Medicine, Ewha Woman's University, College of Medicine, Ewha Woman's University Mokdong Hospital, Seoul, South Korea.

Abstract

AIM:

We determined if differences in renal function, even within normal levels, influenced hippocampal volume (HCV) and cognition.

METHODS:

Cognitively normal (CN) and mild cognitive impairment (MCI) subjects with eGFR ≥ 60 ml/min/1.73m2 were selected from the ADNI database (N = 1,269) and divided into three groups (eGFR 60-75, 75-90 and ≥90). Associations between eGFR, HCV and cognition scores were examined using regression methods, and random-coefficient models. The relationship between various factors, such as vascular burden and brain amyloid deposition, were investigated using path analysis.

RESULTS:

Higher eGFR was associated with larger HCVs and better cognition in all subjects at baseline. In MCI subjects, hippocampal atrophy in the eGFR ≥ 90 group progressed at just half the rate of the eGFR 75-90 group (P = .006), and was also somewhat slower than the eGFR 60-75 group (P = .08). A comprehensive path model linking eGFR, HCV and cognition, and integrating vascular burden and amyloid deposition, is proposed.

CONCLUSIONS:

Higher renal function was associated with slower hippocampal atrophy and cognitive decline even within normal levels of renal function. This relationship was mediated mainly through cardiovascular risk burden and amyloid deposition. Further studies examining neuroinflammation are needed. Geriatr Gerontol Int 2017; 17: 1899-1906.

KEYWORDS:

dementia; glomerular filtration rate; hippocampus; kidney; vascular burden

PMID:
28224692
DOI:
10.1111/ggi.12985
[Indexed for MEDLINE]

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