Association of renal impairment with cognitive dysfunction in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA)

Euan N Paterson, Alexander P Maxwell, Frank Kee, Sharon Cruise, Ian S Young, Bernadette McGuinness, Gareth J McKay

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: Chronic kidney disease (CKD) is a recognised risk factor for cognitive impairment. Identification of those at greatest risk of cognitive impairment may facilitate earlier therapeutic intervention. This study evaluated associations between estimated glomerular filtration rate (eGFR) and cognitive function in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).

METHODS: Data were available for 3,412 participants ≥ 50 years old living in non-institutionalised settings who attended a health assessment between Feb 2014 and Mar 2016. Measures of serum creatinine (cr) and cystatin-C (cys) were used for eGFR. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Examination (MMSE).

RESULTS: Following adjustment for potential confounders, a single unit decrease in eGFR was significantly associated with reduced cognitive function defined by MMSE ≤24/30 (eGFRcys: β -0.01, 95% confidence intervals [CI]: -0.001, -0.01; p = 0.01) and MoCA <26/30 (β -0.01, 95% CI: -0.002, -0.02; p = 0.02). Similarly, CKD stages 3-5 were also associated with a moderate increase in the odds of cognitive impairment (MMSE ≤ 24) following adjustment for confounders (eGFRcys: OR 2.73, 95% CI: 1.38, 5.42, p = 0.004).

CONCLUSIONS: Decreased eGFRcys was associated with a significantly increased risk of cognitive impairment in a population-based cohort of older adults. However, there was no evidence of association between cognitive impairment and the more commonly used eGFRcr-based calculation. eGFRcys may offer improved sensitivity over eGFRcr in the determination of renal function and associated risk of cognitive impairment.

Bibliographical note

© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA.

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