Key result
Severe decline in estimated glomerular filtration rate (>20% per year) was associated with a 33% increased risk of cognitive deterioration compared to stable eGFR in older adults.
Why the study?
Does severe annual decline in eGFR increase the risk of cognitive deterioration or death in community-dwelling elderly individuals?
Cohort (n=33,654)
No
Does severe annual decline in eGFR increase the risk of cognitive deterioration or death in community-dwelling elderly individuals?
Hazard Ratio: 1.33 (95% CI 1.08–1.72)
Absolute Event Rate: 8.2% vs 5.3%
Severe annual decline in eGFR (>20%) is an independent predictor of progressive cognitive deterioration and all-cause mortality in community-dwelling older adults.
Rapid eGFR decline may warrant cognitive vigilance in elderly; extends associations but leaves open causal trials.
Cognitive dysfunction is closely related to aging and chronic kidney disease (CKD). However, the association between renal function changes and the risk of developing cognitive impairment has not been elucidated. This longitudinal cohort study was to determine the influence of annual percentage change in estimated glomerular filtration rate (eGFR) on subsequent cognitive deterioration or death of the elderly within the community. A total of 33,654 elders with eGFR measurements were extracted from the Taipei City Elderly Health Examination Database. The Short Portable Mental Status Questionnaire was used to assess their cognitive progression at least twice during follow-up visits. Multivariable Cox regression models were used to estimate the hazard ratio (HR) for cognitive deterioration or all-cause mortality with the percentage change in eGFR. During a median follow-up of 5.4 years, the participants with severe decline in eGFR (>20% per year) had an increased risk of cognitive deterioration (HR, 1.33; 95% confidence interval [CI], 1.08-1.72) and the composite outcome (HR, 1.17; 95% CI, 1.03-1.35) when compared with those who had stable eGFR. Severe eGFR decline could be a possible predictor for cognitive deterioration or death among the elderly. Early detection of severe eGFR decline is a critical issue and needs clinical attentions.
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Chen et al. (2017) conducted a cohort in Normal cognitive function at baseline (n=33,654). Severe decline in estimated glomerular filtration rate (>20% per year) vs. Stable eGFR (change between -20% and +20% per year) was evaluated on Cognitive deterioration (≥ 3 errors on the SPMSQ) (HR 1.33, 95% CI 1.08-1.72). Severe decline in estimated glomerular filtration rate (>20% per year) was associated with a 33% increased risk of cognitive deterioration compared to stable eGFR in older adults.
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