“Dual Burden of Kidney Disease and Cognitive Impairment in LASI-DAD-Cohort”

INTRODUCTION Chronic kidney disease (CKD) and cognitive impairment are being increasingly recognized as major public health challenges in aging populations, yet their interrelationship remains underexplored in India. METHODS Data from Longitudinal Aging Study in India- Diagnostic Assessment of Dementia (LASI-DAD) cohort was analysed. eGFR was estimated using serum creatinine, cystatin C, and combined CKD-EPI equations. Cognitive performance was assessed using Hindi Mental State Examination (HMSE) and domain-specific cognitive tests. RESULTS The prevalence of eGFR <60 mL/min/1.73 m 2 was 22.66% using CKD-EPI creatinine-cystatin C (eGFRcr-cys) representing one of the highest reported estimates among community-dwelling older adults. Reduced eGFR showed null associations with HMSE scores and performance in cognitive domains. Risk of cognitive impairment was similar in those with eGFR ≥60 mL/min/1.73 m 2 when compared to eGFR <60 mL/min/1.73 m 2 . However, the creatinine/cystatin C ratio demonstrated a positive association (ρ = 0.18, P value < 0.001) with cognitive performance. CONCLUSION No significant association between eGFR and cognition was found in LASI-DAD cohort. High prevalence of reduced eGFR and cognitive impairment may be attributed to age, modifiable risk factors and region specific differences, highlighting the need for further longitudinal research in low and middle income countries.