Association of renal impairment with cognitive dysfunction in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).
Association of renal impairment with cognitive dysfunction in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA).
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DOI：
10.1093/ndt/gfab182
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发表时间：
2021-07-23
期刊：
影响因子：
--
通讯作者：
McKay GJ
中科院分区：
文献类型：
--
作者：
Paterson EN;Maxwell AP;Kee F;Cruise S;Young IS;McGuinness B;McKay GJ
慢性肾脏疾病(CKD)是公认的认知障碍的危险因素。识别那些认知损害风险最大的人可能有助于早期治疗干预。这项研究评估了北爱尔兰老龄化纵向研究队列中估计的肾小球滤过率(EGFR)和认知功能之间的关系。有3,412名生活在非制度化环境中的50岁≥ 参与者的数据，他们在2014年2月至2016年3月期间参加了一项健康评估。采用血清肌酐(Scr)和半胱氨酸氨基转移酶C(Cys-C)测定EGFR。采用蒙特利尔认知评估(MoCA)和简易智力状态检查(MMSE)评估认知功能。在调整潜在混杂因素后，EGFR的单个单位下降与认知功能下降显著相关，由MMSE ≤24/30[EGFR使用血清Cys-C计算：β=−0.01[95%可信区间(CI)−0.001至−0.01]，P = 0.01}和26/30[β=−0.01(95%CI−0.002至−0.02)，P = 0.02]。同样，慢性肾脏病3-5期患者在调整混杂因素后，认知损害的风险( ≤24)也有适度增加[eGFRcys：优势比2.73(95%可信区间1.38-5.42)，P = 0.004]。在以人群为基础的老年人队列中，eGFRcys减少与认知损害风险显著增加相关。然而，没有证据表明认知障碍与使用SCR计算的更常用的EGFR之间存在关联。在测定肾功能和相关的认知损害风险方面，eGFRcys可能比eGFRcr具有更高的灵敏度。
Chronic kidney disease (CKD) is a recognized risk factor for cognitive impairment. Identification of those at greatest risk of cognitive impairment may facilitate earlier therapeutic intervention. This study evaluated associations between estimated glomerular filtration rate (eGFR) and cognitive function in the Northern Ireland Cohort for the Longitudinal Study of Ageing. Data were available for 3412 participants ≥50 years of age living in non-institutionalized settings who attended a health assessment between February 2014 and March 2016. Measures of serum creatinine (SCr) and cystatin C (cys-C) were used for eGFR. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Following adjustment for potential confounders, a single unit decrease in eGFR was significantly associated with reduced cognitive function defined by an MMSE ≤24/30 {eGFR calculated using serum cys-C [eGFRcys]: β = −0.01 [95% confidence interval (CI) −0.001 to −0.01], P = 0.01} and MoCA <26/30 [β = −0.01 (95% CI −0.002 to −0.02), P = 0.02]. Similarly, CKD Stages 3–5 were also associated with a moderate increase in the odds of cognitive impairment (MMSE ≤24) following adjustment for confounders [eGFRcys: odds ratio 2.73 (95% CI 1.38–5.42), P = 0.004]. Decreased eGFRcys was associated with a significantly increased risk of cognitive impairment in a population-based cohort of older adults. However, there was no evidence of an association between cognitive impairment and the more commonly used eGFR calculated using SCr. eGFRcys may offer improved sensitivity over eGFRcr in the determination of renal function and associated risk of cognitive impairment.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
DOI：
10.1016/s0140-6736(18)31694-5
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
Foreman KJ;Marquez N;Dolgert A;Fukutaki K;Fullman N;McGaughey M;Pletcher MA;Smith AE;Tang K;Yuan CW;Brown JC;Friedman J;He J;Heuton KR;Holmberg M;Patel DJ;Reidy P;Carter A;Cercy K;Chapin A;Douwes-Schultz D;Frank T;Goettsch F;Liu PY;Nandakumar V;Reitsma MB;Reuter V;Sadat N;Sorensen RJD;Srinivasan V;Updike RL;York H;Lopez AD;Lozano R;Lim SS;Mokdad AH;Vollset SE;Murray CJL
通讯作者：
Murray CJL
影响因子：
19.6
作者：
通讯作者：
--
影响因子：
5
作者：
Darsie, Brendan;Shlipak, Michael G.;Odden, Michelle C.
通讯作者：
Odden, Michelle C.
影响因子：
48
作者：
Barnes, Deborah E.;Yaffe, Kristine
通讯作者：
Yaffe, Kristine