Abstract
Background: Renal disease has been associated with greater risk of dementia and greater cognitive impairment. However, the relationship of lower renal function with long-term decline in specific domains of cognitive function remains unclear among community-dwelling, non-demented individuals. Methods: Stroke- and dementia-free participants (n = 2,116) were enrolled in the Baltimore Longitudinal Study of Aging, a community-based, prospective, longitudinal study. Renal function was estimated by the inverse of serum creatinine adjusted for age, sex and race and (in sensitivity analyses) estimated glomerular filtration rate (eGFR) using the MDRD formula. Outcome measures were changes in scores on 6 cognitive tests encompassing a range of cognitive functions, measured at 2-year intervals. Mixed-effects regression models examined the longitudinal relations of renal function with cognitive functions after adjusting for demographics, comorbidity and other potential confounders. Results: Mean age at initial testing was 53.9 years (SD 17.1), and 94 participants (4.4%) had an eGFR 2 and 18.5% had at least one comorbidity. With increasing age, longitudinal increases in creatinine concentrations were associated with more rapid decline in performance on several cognitive measures, including the learning slope of the California Verbal Learning Test, a test of verbal learning (p <0.01), and the Benton Visual Retention Test, a test of visual memory (p <0.01). Associations were similar for changes in eGFRMDRD, which was also associated with the rate of decline in verbal memory. Conclusion: In a community-based adult population, declines in renal function independently associated with greater long-term declines in visual memory and verbal memory and learning.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 305-312 |
| Number of pages | 8 |
| Journal | American Journal of Nephrology |
| Volume | 41 |
| Issue number | 4-5 |
| DOIs | |
| State | Published - Jul 25 2015 |
| Externally published | Yes |
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Keywords
- Cognitive function
- Creatinine
- Estimated glomerular filtration rate
- Kidney function
- Longitudinal trajectories
- Neuropsychology
ASJC Scopus subject areas
- Nephrology
Cite this
Renal Function and Long-Term Decline in Cognitive Function : The Baltimore Longitudinal Study of Aging. / Seliger, Stephen L.; Wendell, Carrington R.; Waldstein, Shari R.; Ferrucci, Luigi; Zonderman, Alan B.
In: American Journal of Nephrology, Vol. 41, No. 4-5, 25.07.2015, p. 305-312.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Renal Function and Long-Term Decline in Cognitive Function
T2 - The Baltimore Longitudinal Study of Aging
AU - Seliger, Stephen L.
AU - Wendell, Carrington R.
AU - Waldstein, Shari R.
AU - Ferrucci, Luigi
AU - Zonderman, Alan B.
PY - 2015/7/25
Y1 - 2015/7/25
N2 - Background: Renal disease has been associated with greater risk of dementia and greater cognitive impairment. However, the relationship of lower renal function with long-term decline in specific domains of cognitive function remains unclear among community-dwelling, non-demented individuals. Methods: Stroke- and dementia-free participants (n = 2,116) were enrolled in the Baltimore Longitudinal Study of Aging, a community-based, prospective, longitudinal study. Renal function was estimated by the inverse of serum creatinine adjusted for age, sex and race and (in sensitivity analyses) estimated glomerular filtration rate (eGFR) using the MDRD formula. Outcome measures were changes in scores on 6 cognitive tests encompassing a range of cognitive functions, measured at 2-year intervals. Mixed-effects regression models examined the longitudinal relations of renal function with cognitive functions after adjusting for demographics, comorbidity and other potential confounders. Results: Mean age at initial testing was 53.9 years (SD 17.1), and 94 participants (4.4%) had an eGFR 2 and 18.5% had at least one comorbidity. With increasing age, longitudinal increases in creatinine concentrations were associated with more rapid decline in performance on several cognitive measures, including the learning slope of the California Verbal Learning Test, a test of verbal learning (p <0.01), and the Benton Visual Retention Test, a test of visual memory (p <0.01). Associations were similar for changes in eGFRMDRD, which was also associated with the rate of decline in verbal memory. Conclusion: In a community-based adult population, declines in renal function independently associated with greater long-term declines in visual memory and verbal memory and learning.
AB - Background: Renal disease has been associated with greater risk of dementia and greater cognitive impairment. However, the relationship of lower renal function with long-term decline in specific domains of cognitive function remains unclear among community-dwelling, non-demented individuals. Methods: Stroke- and dementia-free participants (n = 2,116) were enrolled in the Baltimore Longitudinal Study of Aging, a community-based, prospective, longitudinal study. Renal function was estimated by the inverse of serum creatinine adjusted for age, sex and race and (in sensitivity analyses) estimated glomerular filtration rate (eGFR) using the MDRD formula. Outcome measures were changes in scores on 6 cognitive tests encompassing a range of cognitive functions, measured at 2-year intervals. Mixed-effects regression models examined the longitudinal relations of renal function with cognitive functions after adjusting for demographics, comorbidity and other potential confounders. Results: Mean age at initial testing was 53.9 years (SD 17.1), and 94 participants (4.4%) had an eGFR 2 and 18.5% had at least one comorbidity. With increasing age, longitudinal increases in creatinine concentrations were associated with more rapid decline in performance on several cognitive measures, including the learning slope of the California Verbal Learning Test, a test of verbal learning (p <0.01), and the Benton Visual Retention Test, a test of visual memory (p <0.01). Associations were similar for changes in eGFRMDRD, which was also associated with the rate of decline in verbal memory. Conclusion: In a community-based adult population, declines in renal function independently associated with greater long-term declines in visual memory and verbal memory and learning.
KW - Cognitive function
KW - Creatinine
KW - Estimated glomerular filtration rate
KW - Kidney function
KW - Longitudinal trajectories
KW - Neuropsychology
UR - http://www.scopus.com/inward/record.url?scp=84937961455&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84937961455&partnerID=8YFLogxK
U2 - 10.1159/000430922
DO - 10.1159/000430922
M3 - Article
C2 - 26201453
AN - SCOPUS:84937961455
VL - 41
SP - 305
EP - 312
JO - American Journal of Nephrology
JF - American Journal of Nephrology
SN - 0250-8095
IS - 4-5
ER -