Albuminuria and Dementia in the Elderly: A Community Study

Joshua I. Barzilay, Annette L. Fitzpatrick, Jose Luchsinger, Sevil Yasar, Charles Bernick, Nancy S. Jenny, Lewis H. Kuller

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)216-226
Number of pages11
JournalAmerican Journal of Kidney Diseases
Volume52
Issue number2
DOIs
StatePublished - Aug 2008

Keywords

  • Albuminuria
  • dementia
  • elderly
  • magnetic resonance imaging (MRI) brain
  • mild cognitive impairment

ASJC Scopus subject areas

  • Nephrology

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    Barzilay, J. I., Fitzpatrick, A. L., Luchsinger, J., Yasar, S., Bernick, C., Jenny, N. S., & Kuller, L. H. (2008). Albuminuria and Dementia in the Elderly: A Community Study. American Journal of Kidney Diseases, 52(2), 216-226. https://doi.org/10.1053/j.ajkd.2007.12.044