Albuminuria and Dementia in the Elderly: A Community Study
Received 8 July 2007; accepted 26 December 2007. published online 13 May 2008.
Refers to article:
The Cognition–Kidney Disease Connection: Lessons From Population-Based Studies in the United States
Daniel E. Weiner
American Journal of Kidney Diseases
August 2008 (Vol. 52, Issue 2, Pages 201-204) Full Text |
Full-Text PDF (131 KB)
Background
Dementia is associated with microvascular disease of the retina. In this study, we examine whether cognitive status (normal cognition, mild cognitive impairment, and dementia) is associated with albuminuria, a microvascular disorder of the kidney.
Study Design
Cross-sectional analysis.
Setting & Participants
2,316 participants from the Cardiovascular Health Cognition Study who underwent brain magnetic resonance imaging and testing for albuminuria.
Predictor
Doubling of albuminuria.
Outcome
Dementia defined according to neuropsychological and clinical evaluation.
Measurements
Multinomial logistic modeling was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of dementia and mild cognitive impairment with doubling of albuminuria compared with the odds with normal cognition.
Results
283 participants (12.2%) had dementia, 344 (14.9%) had mild cognitive impairment, and 1,689 (72.9%) had normal cognition. Compared with participants with normal cognition, doubling of albuminuria was associated with increased odds of dementia (OR, 1.22; 95% CI, 1.15 to 1.29). Adjustment for prevalent cardiovascular disease and cardiovascular risk factors, lipid levels, C-reactive protein level, estimated glomerular filtration rate, and apolipoprotein E-4 genotype attenuated this association, but it remained statistically significant (OR, 1.12; 95% CI, 1.03 to 1.22). Mild cognitive impairment was associated with albuminuria on unadjusted analysis, but not with adjustment for other factors.
Limitations
Results are cross-sectional; causality cannot be imputed.
Conclusions
The odds of dementia increased in the presence of albuminuria. These findings suggest a role of shared susceptibility for microvascular disease in the brain and kidney in older adults.
ABSTRACT