A Prospective Study of Albuminuria and Cognitive Function in Older Adults The Rancho Bernardo Study

Chronic kidney disease is a risk factor for cognitive impairment. Albuminuria is an early manifestation of chronic kidney disease and a marker of endothelial dysfunction and vascular risk. Results of prior studies of albuminuria and cognitive function are contradictory. The authors studied 1,345 com...

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Bibliographic Details
Published in:American journal of epidemiology 2010-02, Vol.171 (3), p.277-286
Main Authors: JASSAL, Simerjot K, KRITZ-SILVERSTEIN, Donna, BARRETT-CONNOR, Elizabeth
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Albuminuria - epidemiology
Analysis. Health state
Associated diseases and complications
Biological and medical sciences
California - epidemiology
Cognition
Cognitive ability
Creatinine - urine
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Epidemiology
Female
General aspects
Glomerular Filtration Rate
Humans
Intelligence Tests
Kidney Diseases - epidemiology
Kidneys
Male
Medical disorders
Medical research
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Neurology
Older people
Original Contributions
Prospective Studies
Public health. Hygiene
Public health. Hygiene-occupational medicine
Urinary system involvement in other diseases. Miscellaneous
Urine
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Summary:Chronic kidney disease is a risk factor for cognitive impairment. Albuminuria is an early manifestation of chronic kidney disease and a marker of endothelial dysfunction and vascular risk. Results of prior studies of albuminuria and cognitive function are contradictory. The authors studied 1,345 community-dwelling women and men in southern California (mean age, 75 years) at a 1992-1996 research clinic visit, when urine albumin/creatinine ratio (ACR) was measured in spot morning urine and cognitive function was evaluated by using the Mini-Mental State Examination Trail-Making Test B, and category fluency test. An ACR of > or =30 mg/g was found in 17% of women and 15% of men in 1992-1996. Analysis of covariance was used to compare cognitive function score by categorical ACR. Between 1999 and 2002, 759 participants returned for repeat cognitive function testing. For men, but not women, baseline albuminuria, but not estimated glomerular filtration rate, was associated with reduced cognitive function at follow-up on all tests (P's < 0.05). An ACR of > or =30 mg/g was associated with greater annual decline in Mini-Mental State Examination and category fluency scores. Albuminuria may be an easily measured marker predicting future cognitive function decline. Results imply a common underlying mechanism affecting the renal and cerebral microvasculature.
ISSN:0002-9262
1476-6256
DOI:10.1093/aje/kwp426