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Kidney Week

Abstract: TH-PO655

Renal Function Does Not Have a Graded Inverse Association with Cognition in the Elderly

Session Information

  • Geriatric Nephrology
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

  • 1100 Geriatric Nephrology

Authors

  • Gupta, Aditi, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Kennedy, Kevin F., Independent, Overland park, Kansas, United States
  • Beddhu, Srinivasan, University of Utah School of Medicine, Sandy, Utah, United States
  • Burns, Jeffrey M., University of Kansas School of Medicine, Kansas City, Kansas, United States
Background

Studies have shown a graded relation between estimated glomerular filtration (eGFR) and cognition. However, these studies are limited by inadequate matching at baseline, poor selection of neuropsychological tests (use of tests meant for screening to assess cognition) or low numbers of older participants. In this study we used data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), a NIH funded, longitudinal multicenter study for the early detection and tracking of cognitive impairment and dementia, to explore the association between eGFR and cognition in older adults.

Methods

We compared previously validated composite scores for memory and executive function in ADNI participants with and without cognitive impairment to assess the association with eGFR. We used CKD-epi equation for calculating eGFR. We divided the groups with and without cognitive impairment by baseline eGFR into <45, 45-60, 61-90 and >90 ml/min and analyzed differences in cognition between these groups. We also performed a linear multivariable analysis taking memory and executive function as the dependent variable and eGFR as a continuous independent variable.

Results

There were 1181 ADNI participants, 805 with cognitive impairment and 376 without (with available creatinine values at baseline). The mean ages were 73.3±7.7 and 74.5±5.6 respectively (p=0.006). Those with cognitive impairment were more likely male (58.6% vs 51.3%, p=0.018), and married (79.3% vs 68.6%, p=0.001). Race and ethnicity did not differ between the two groups (p>0.2). Mean eGFR was higher in the group with cognitive impairment (66.1±14) compared to the group with no cognitive impairment (63.9±14.8) (p=0.014). 6% of the participants had a eGFR<45, 22% eGFR 45-60, 51% eGFR 60-90, and 21% eGFR>90. In our multivariable model, memory scores decreased by 0.177 (p<0.001) and executive scores by 0.32 (p<0.001) for every 10 years increase in age in the entire cohort. Lower education was associated with lower memory and executive scores (p<0.001). There was no association between eGFR and memory (p=0.598) or executive scores (p=0.223) in the entire cohort.

Conclusion

We did not find an inverse relationship eGFR and cognitive impairment in the elderly in the ADNI Study.

Funding

  • Other NIH Support