Abstract: SA-PO948
Assessing Cognition and Sex Differences in CKD Using the NIH Toolbox
Session Information
- CKD: Observational Research and Patient-Oriented Interventions
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials
Authors
- Perez, Luis M., University of Colorado Denver School of Medicine, Aurora, Colorado, United States
- Furgeson, Seth B., University of Colorado Denver School of Medicine, Aurora, Colorado, United States
- You, Zhiying, University of Colorado Denver School of Medicine, Aurora, Colorado, United States
- Kendrick, Jessica B., University of Colorado Denver School of Medicine, Aurora, Colorado, United States
Background
Chronic kidney disease (CKD) is largely an age-related clinical disorder with accelerated cognitive and cardiovascular aging. Cognitive impairment is a well-documented occurrence in midlife and older adults with CKD and affects multiple domains. In the general population, there is a higher prevalence of cognitive impairment in women. We examined whether cognition differed by sex in adults with CKD.
Methods
We included 109 individuals (51% women) with CKD stage 3b-4 (eGFR 15-44 ml/min) from the Bicarbonate Administration in CKD Trial. We measured cognitive function using the National Institute of Health (NIH) Toolbox® (TB) cognitive battery, which assesses cognitive and motor measures such as executive function, attention, memory, and dexterity. All study measures were collected and analyzed at the study baseline.
Results
The mean age and eGFR were 61 ± 12 years and 34.9 ± 9.8 ml/min/1.73m2. Overall, both men and women scored below the 50th percentile on all fluid cognition measures, dexterity and total fluid and total cognition scores (Table). Notably, men scored higher than women on the flanker test (11±21 pts, p<0.01). However, women scored higher on both the dominant/non-dominant pegboard test (12±16 pts, p<0.01, 10±15, p=0.01 respectively). There were no other sex differences among other cognitive measures (all p>0.05). EGFR was associated only with crystallized cognition (r=-0.26, p<0.01).
Conclusion
Individuals with CKD had cognitive function below the median NIH-TB reference population values. These results establish baseline cognitive impairment levels in individuals with CKD as well as sex differences in cognitive measures.
NIH-TB Cognitive Battery Scores
| Measure | Uncorrected score (mean ± SD) | Corrected score (mean ± SD) | Percentile (mean ± SD) |
| Fluid Cognition Measures | |||
| Flanker Test | 92.9 ± 10.1 | 42.5 ± 7.7 | 28.4 ± 21.2 |
| List Sort | 95.5 ± 12.7 | 48.8 ± 10.2 | 46.1 ± 29.9 |
| Pattern Comparison | 87.7 ± 14.8 | 44.4 ± 11.9 | 35.9 ± 30.9 |
| Picture Sequence | 94.5 ± 13.0 | 48.4 ± 9.4 | 43.3 ± 28.5 |
| Card Sort Test | 97.1 ± 12.2 | 50.5 ± 10.9 | 48.4 ± 31.8 |
| Dexterity | |||
| Peg board (dominant) | 90.5 ± 17.3 | 42.2 ± 10.1 | 27.6 ± 24.0 |
| Peg board (non-dominant) | 93.1 ± 16.6 | 43.7 ± 8.7 | 31.8 ± 24.2 |
| Total Cognition Measures | |||
| Fluid cognition | 89.7 ± 13.1 | 45.2 ± 10.4 | 38.1 ± 30.4 |
| Crystallized cognition | 107.4 ± 10.0 | 51.7 ± 8.7 | 54.1 ± 27.6 |
| Total cognition | 97.3 ± 11.7 | 48.2 ± 9.0 | 44.7 ± 29.1 |
Funding
- NIDDK Support