Cognitive Decline in Chronic Renal Insufficiency

慢性肾功能不全的认知能力下降

• 批准号: 7478115
• 负责人: Kristine Yaffe
• 金额: $ 46.83万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7478115
• 关键词: Address; Adherence; Age; Ancillary Study; Attention; Cardiovascular Diseases; Cerebrovascular Disorders; Chronic; Chronic Kidney Insufficiency; Classification; Clinical; Cognition; Cognitive; Cognitive aging; Cohort Studies; Data; Diabetes Mellitus; Disease; Drug usage; Dyslipidemias; Education; Elderly; Enrollment; Epidemiology; Ethnic Origin; Ethnic group; Functional disorder; Funding; Glomerular Filtration Rate; Goals; Healthcare; High Prevalence; Hypertension; Impaired cognition; Individual; Inflammation; Inflammatory; Inpatients; Kidney; Kidney Diseases; Kidney Failure; Link; Lobe; Mediating; Mediator of activation protein; Modeling; Monitor; Myocardial Infarction; Nature; Outcome; Participant; Patient Care; Patients; Population; Prospective Studies; Public Health; Quality of life; Race; Research Personnel; Risk Factors; Screening procedure; Severities; Socioeconomic Status; Stroke; Subgroup; Testing; Time; Vascular calcification; Work; burden of illness; cardiovascular disorder risk; cognitive function; cohort; cost; health care service utilization; improved; modifiable risk; novel

Chronic renal insufficiency (CRI) and cognitive impairment are common diseases in the elderly, both associated with increased health-care utilization and decreased quality of life. Whether CRI is associated with accelerated cognitive aging over time has not been addressed. We have preliminary cross-sectional evidence that CRI may be associated with cognitive impairment in the elderly, but no prospective studies have been conducted on the relationship between CRI and cognitive,outcomes. If such an association can be established, the clinical care of patients could be directly influenced by screening for cognitive impairment, more close monitoring of treatment adherence and the use of drugs and other strategies to improve cognition. The goals of this proposal are to investigate whether severity of CRI is associated with greater cognitive decline in older individuals with CRI, to assess whether the relation between CRI and cognitive function is modified by targeted demographic and clinical factors, and to examine potential mechanisms of cognitive decline, such as cardiovascular disease and inflammation. Our aims will be addressed as an ancillary study to the ongoing NIDDK-funded Chronic Renal Insufficiency Cohort (CRIC) study. This prospective study will examine the epidemiology and outcomes of CRI in a large, representative population of patients with CRI. Among 720 older CRIC participants who enroll in the proposed CRIC Cognitive Function Ancillary Study, we will cost-efficiently 1) determine the association between CRI and 3-4 year cognitive decline among CRIC participants over age 55 years; 2) evaluatewhether the association between CRI and cognitive decline is consistent among different patient subgroups such as those of different races and ethnicities, and those with and without diabetes mellitus; 3) elucidate several mechanisms that may mediate the association between CRI and cognitive decline, including cardiovascular disease and inflammation. Assessing the nature of cognitive impairment in a representative population with CRI will provide crucial data for determiningthe burden of disease and health care needs of those with CRI. Moreover, understandingthese relations may help to identify potential modifiable risk factors and to treat cognitive impairment thereby maintaining independence among patients with renal disease.

慢性肾功能不全（CRI）和认知功能障碍是老年人的常见疾病， 与医疗保健利用增加和生活质量下降有关。CRI是否与 随着时间的推移加速的认知老化还没有得到解决。我们有初步的横向证据 CRI可能与老年人的认知障碍有关，但目前还没有前瞻性研究表明， CRI和认知结果之间的关系。如果能够建立这样的联系， 患者的临床护理可能直接受到认知障碍筛查的影响， 监测治疗依从性和使用药物及其他改善认知的策略。的目标 这项建议的目的是调查CRI的严重程度是否与老年人更大的认知能力下降有关。 CRI患者，以评估CRI和认知功能之间的关系是否被以下因素改变： 有针对性的人口统计学和临床因素，并检查认知能力下降的潜在机制，如 心血管疾病和炎症。 我们的目标将作为正在进行的NIDDK资助的慢性肾功能不全的辅助研究 队列研究。这项前瞻性研究将在一个大的， CRI患者的代表性人群。在720名参加审评委的老年人中， 建议的CRIC认知功能辅助研究，我们将成本效益1）确定关联 在55岁以上的CRIC参与者中，CRI与3-4年认知能力下降之间的关系; 2）评估是否 CRI和认知能力下降之间的关联在不同的患者亚组中是一致的， 不同种族和民族的人，以及患有和不患有糖尿病的人; 3）阐明几个 可能介导CRI和认知能力下降之间关联的机制，包括心血管 疾病和炎症。在具有代表性的人群中评估认知障碍的性质 CRI将为确定CRI患者的疾病负担和医疗保健需求提供关键数据。 此外，了解这些关系可能有助于识别潜在的可改变的风险因素， 认知障碍，从而维持肾病患者的独立性。