期刊
ALZHEIMERS RESEARCH & THERAPY
卷 13, 期 1, 页码 -出版社
BMC
DOI: 10.1186/s13195-020-00729-9
关键词
Glomerular filtration rate; Kidney function; Dementia; Cognitive decline; Older adults
资金
- National key Research and development program [2020YFC2005003, 2018YFC2000204]
- Scientific Research Plan Project of Shanghai Science and Technology Committee [17411950701, 17411950106]
- National Natural Science Foundation of China [81773513, 81730017, 81570665, 81600577]
- Shanghai Shenkang three-year action project [SHDC2020CR4014]
- Shanghai Municipal Science and Technology Major Project [2018SHZDZX03]
- ZJ LAB, Shanghai Medical leader project [2019LJ03]
- National Project of Chronic Disease [2016YFC1306400]
This study followed 1,412 Chinese elderly individuals for an average of 5.3 years and found that lower levels of kidney function were associated with an increased risk of dementia. The results suggest that GFR(crcys) may serve as a marker for vulnerability to cognitive decline.
Background Association between kidney dysfunction and dementia has been studied in western cohorts, but with inconsistent conclusions which may be due to the different measurements of kidney function. We aim to verify the hypothesis that lower levels of kidney function would be associated with increased risk of incident dementia in Chinese elderly. Methods One thousand four hundred twelve dementia-free participants aged 60 years or older from the Shanghai Aging Study were enrolled and followed up for 5.3 years on average. Glomerular filtration rate (GFR) was calculated by using combined creatinine-cystatin C CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Diagnoses of incident dementia and Alzheimer's disease (AD) were established using DSM-IV and NINCDS-ADRDA criteria based on medical, neurological, and neuropsychological examinations to each participant. Cox proportional regression was used to analyze the association of baseline GFR(crcys) levels with incident dementia/AD, adjusting age, gender, education years, APOE-epsilon 4, diabetes, hypertension, baseline Mini-Mental State Examination score, and proteinuria. Results A total of 113 (8%) and 84 (7%) participants developed dementia and AD. Comparing to participants with high GFR(crcys) (>= 80 ml/min/1.73 m(2)), participants with low (< 67 ml/min/1.73 m(2)) and moderate GFR(crcys) (67 <= GFR < 80 ml/min/1.73 m(2)) had increased risk of incident dementia with hazard ratios (HRs) of 1.87 (95% CI 1.02-3.44) and 2.19 (95% CI 1.21-3.95) after adjustment for confounders, respectively. Low (HR = 2.27 [95%CI 1.10-4.68]) and moderate (HR = 2.14 [95% CI 1.04-4.40]) GFR(crcys) at baseline was also independently associated with incident AD after adjustments when comparing to high GFR(crcys). The significant association between GFR(crcys) and dementia risk was observed in female but not in male participants. Conclusions GFR(crcys) may be considered as a marker of an individual's vulnerability to the increased risk of cognitive decline.
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