期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 180, 期 1, 页码 68-75出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwu102
关键词
aging; chronic kidney disease; cognitive function; congestive heart failure; myocardial infarction; prospective study; stroke; successful aging
资金
- National Heart, Lung, and Blood Institute [HHSN268201200036C, HHSN 268200800007C, N01HC55222, N01HC85079, N01HC 85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, HL080295]
- National Institute on Aging [R01AG023629, R01AG027002, K01AG039387]
- American Heart Association Western States Affiliate [11CRP7210088]
Recent evidence has demonstrated the importance of kidney function in healthy aging. We examined the association between kidney function and change in cognitive function in 3,907 participants in the Cardiovascular Health Study who were recruited from 4 US communities and studied from 1992 to 1999. Kidney function was measured by cystatin C-based estimated glomerular filtration rate (eGFR(cys)). Cognitive function was assessed using the Modified Mini-Mental State Examination and the Digit Symbol Substitution Test, which were administered up to 7 times during annual visits. There was an association between eGFR(cys) and change in cognitive function after adjustment for confounders; persons with an eGFR(cys) of less than 60 mL/minute/1.73 m(2) had a 0.64 (95% confidence interval: 0.51, 0.77) points/year faster decline in Modified Mini-Mental State Examination score and a 0.42 (95% confidence interval: 0.28, 0.56) points/year faster decline in Digit Symbol Substitution Test score compared with persons with an eGFR(cys) of 90 or more mL/minute/1.73 m(2). Additional adjustment for intermediate cardiovascular events modestly affected these associations. Participants with an eGFR(cys) of less than 60 mL/minute/1.73 m(2) had fewer cognitive impairment-free life-years on average compared with those with eGFR(cys) of 90 or more mL/minute/1.73 m(2), independent of confounders and mediating cardiovascular events (mean difference = -0.44, 95% confidence interval: -0.62, -0.26). Older adults with lower kidney function are at higher risk of worsening cognitive function.
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