TY - JOUR
T1 - Albuminuria and Dementia in the Elderly
T2 - A Community Study
AU - Barzilay, Joshua I.
AU - Fitzpatrick, Annette L.
AU - Luchsinger, Jose
AU - Yasar, Sevil
AU - Bernick, Charles
AU - Jenny, Nancy S.
AU - Kuller, Lewis H.
N1 - Funding Information:
Support: This study was supported by Contracts NO1-HC-85079 through NO1-HC-85086, NO1-HC-35129, and NO1-HC-15103 from the National Heart, Lung, and Blood Institute. Financial Disclosure: None.
PY - 2008/8
Y1 - 2008/8
N2 - Background: Dementia is associated with microvascular disease of the retina. In this study, we examine whether cognitive status (normal cognition, mild cognitive impairment, and dementia) is associated with albuminuria, a microvascular disorder of the kidney. Study Design: Cross-sectional analysis. Setting & Participants: 2,316 participants from the Cardiovascular Health Cognition Study who underwent brain magnetic resonance imaging and testing for albuminuria. Predictor: Doubling of albuminuria. Outcome: Dementia defined according to neuropsychological and clinical evaluation. Measurements: Multinomial logistic modeling was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of dementia and mild cognitive impairment with doubling of albuminuria compared with the odds with normal cognition. Results: 283 participants (12.2%) had dementia, 344 (14.9%) had mild cognitive impairment, and 1,689 (72.9%) had normal cognition. Compared with participants with normal cognition, doubling of albuminuria was associated with increased odds of dementia (OR, 1.22; 95% CI, 1.15 to 1.29). Adjustment for prevalent cardiovascular disease and cardiovascular risk factors, lipid levels, C-reactive protein level, estimated glomerular filtration rate, and apolipoprotein E-4 genotype attenuated this association, but it remained statistically significant (OR, 1.12; 95% CI, 1.03 to 1.22). Mild cognitive impairment was associated with albuminuria on unadjusted analysis, but not with adjustment for other factors. Limitations: Results are cross-sectional; causality cannot be imputed. Conclusions: The odds of dementia increased in the presence of albuminuria. These findings suggest a role of shared susceptibility for microvascular disease in the brain and kidney in older adults.
AB - Background: Dementia is associated with microvascular disease of the retina. In this study, we examine whether cognitive status (normal cognition, mild cognitive impairment, and dementia) is associated with albuminuria, a microvascular disorder of the kidney. Study Design: Cross-sectional analysis. Setting & Participants: 2,316 participants from the Cardiovascular Health Cognition Study who underwent brain magnetic resonance imaging and testing for albuminuria. Predictor: Doubling of albuminuria. Outcome: Dementia defined according to neuropsychological and clinical evaluation. Measurements: Multinomial logistic modeling was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of dementia and mild cognitive impairment with doubling of albuminuria compared with the odds with normal cognition. Results: 283 participants (12.2%) had dementia, 344 (14.9%) had mild cognitive impairment, and 1,689 (72.9%) had normal cognition. Compared with participants with normal cognition, doubling of albuminuria was associated with increased odds of dementia (OR, 1.22; 95% CI, 1.15 to 1.29). Adjustment for prevalent cardiovascular disease and cardiovascular risk factors, lipid levels, C-reactive protein level, estimated glomerular filtration rate, and apolipoprotein E-4 genotype attenuated this association, but it remained statistically significant (OR, 1.12; 95% CI, 1.03 to 1.22). Mild cognitive impairment was associated with albuminuria on unadjusted analysis, but not with adjustment for other factors. Limitations: Results are cross-sectional; causality cannot be imputed. Conclusions: The odds of dementia increased in the presence of albuminuria. These findings suggest a role of shared susceptibility for microvascular disease in the brain and kidney in older adults.
KW - Albuminuria
KW - dementia
KW - elderly
KW - magnetic resonance imaging (MRI) brain
KW - mild cognitive impairment
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U2 - 10.1053/j.ajkd.2007.12.044
DO - 10.1053/j.ajkd.2007.12.044
M3 - Article
C2 - 18468749
AN - SCOPUS:47149094250
SN - 0272-6386
VL - 52
SP - 216
EP - 226
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -