Chronic Kidney Disease and Silent Brain Infarction Increase the Risk of Vascular Cognitive Impairment in Community-dwelling Elderly Subjects: the Sefuri Study
Chronic Kidney Disease and Silent Brain Infarction Increase the Risk of Vascular Cognitive Impairment in Community-dwelling Elderly Subjects: the Sefuri Study
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慢性肾病和无症状脑梗塞会增加社区老年人血管性认知障碍的风险：Sefuri 研究
DOI：
10.1016/j.jstrokecerebrovasdis.2016.10.002
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Hashimoto M
中科院分区：
文献类型：
--
作者：
Yao H;Araki Y;Takashima Y;Uchino A;Yuzuriha T;Hashimoto M
背景和目的本研究的目的是确定慢性肾病 (CKD)、亚临床脑梗死 (SBI) 和认知障碍之间的复杂关联。方法我们在基于人群的队列中使用结构方程模型 (SEM) 通过简易精神状态检查 (MMSE；全局功能) 和改良斯特鲁普测试 (执行功能) 来检查 CKD、SBI 和认知功能之间的复杂关系 结果基于 SEM 的路径分析显示，从估计肾小球滤过率 (eGFR) 到 SBI 以及从 SBI 到执行功能的直接路径显着（分别为 β = −.10，P= .027 和 β = .16，P< .001）。此外，从 eGFR 到执行功能的直接路径也很显着 (β = −.12,P= .006)，表明 CKD 对执行功能的影响独立于 SBI。从年龄和教育程度到整体认知功能的直接路径非常显着（分别为β = −.17和.22，P< .001），而从eGFR到MMSE的直接路径并不显着。结论我们的研究结果表明，CKD通过依赖和独立于SBI的机制带来血管性认知障碍或执行功能障碍的风险。治疗 CKD 可能是预防健康老年受试者血管性认知障碍或执行功能障碍的潜在策略。
Background and PurposeThe purpose of this study was to determine the complex associations among chronic kidney disease (CKD), subclinical brain infarction (SBI), and cognitive impairment.MethodsWe used structural equation modeling (SEM) to examine the complex relationships among CKD, SBI, and cognitive function with Mini-Mental State Examination (MMSE; global function) and modified Stroop test (executive function) in a population-based cohort of 560 non-demented elderly subjects.ResultsPath analysis based on SEM revealed that the direct paths from estimated glomerular filtration rate (eGFR) to SBI and from SBI to executive function were significant (β = −.10,P= .027, and β = .16,P< .001, respectively). Furthermore, the direct path from eGFR to executive function was also significant (β = −.12,P= .006), indicating that the effects of CKD on executive function are independent of SBI. The direct paths from age and education to global cognitive function were highly significant (β = −.17 and .22, respectively,P< .001), whereas the direct path from eGFR to MMSE was not significant.ConclusionsOur findings indicate that CKD confers a risk of vascular cognitive impairment or executive dysfunction through mechanisms dependent and independent of SBI. Treating CKD may be a potential strategy to protect against vascular cognitive impairment or executive dysfunction in healthy elderly subjects.