Laboratory of Geriatric Neuropsychiatry, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
Laboratory of Analyses, Ospedale Degli Infermi, Biella, Italy.
Nephrology (Carlton). 2020 Jan;25(1):48-54. doi: 10.1111/nep.13579. Epub 2019 Apr 11.
In this study, the relationship between kidney function, cognitive performance, functional abilities and mood was investigated in a community-dwelling Italian oldest-old population.
Serum creatinine was used to calculate estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease formula, for 415 oldest-old without dementia participating in the 'Health and Anemia' study, a prospective, observational cohort study. The cross-sectional associations of kidney function with cognitive performance on several neuropsychological tests, basic and instrumental functional abilities and mood were analyzed using univariate and multivariable linear regression models.
Cognitive performance and functional ability significantly worsened with decreasing kidney function. After adjusting for age, sex, education, comorbidity index of the Cumulative Illness Rating Scale (CIRS), body mass index, bone fracture and serum ferritin levels the associations of eGFR categories with basic and instrumental functional abilities continued to be statistically significant whereas that with global cognitive functions did not. No significant independent association was found between renal function and mood.
Oldest-old with reduced kidney function showed greater basic and instrumental functional disabilities, while cognitive function, although decreased with decreasing eGFR, was no longer significantly associated with eGFR categories after adjusting for confounders.
本研究旨在调查意大利社区居住的高龄老年人中肾功能、认知表现、功能能力和情绪之间的关系。
在“健康和贫血”研究中，对 415 名无痴呆的高龄老年人进行了前瞻性观察性队列研究，使用肾脏病饮食改良公式（MDRD）计算血清肌酐来估算肾小球滤过率（eGFR）。采用单变量和多变量线性回归模型分析肾功能与多项神经心理学测试、基本和工具性功能能力以及情绪的横断面关联。
随着肾功能的下降，认知表现和功能能力显著恶化。在调整年龄、性别、教育程度、累积疾病评分量表（CIRS）的合并症指数、体重指数、骨折和血清铁蛋白水平后，eGFR 类别与基本和工具性功能能力的相关性仍然具有统计学意义，而与总体认知功能的相关性则没有。肾功能与情绪之间没有显著的独立关联。
肾功能降低的高龄老年人表现出更大的基本和工具性功能障碍，而认知功能虽然随着 eGFR 的降低而下降，但在调整混杂因素后，与 eGFR 类别不再有显著相关性。
