Department of Clinical Sciences in Malmö, Division of Geriatric Medicine, Lund University and Skåne University Hospital, Jan Waldenströms gata 35, 205 02, Malmö, Sweden.
BMC Geriatr. 2019 Dec 19;19(1):360. doi: 10.1186/s12877-019-1381-y.
A possible connection on vascular basis between impaired kidney function and cognitive dysfunction has been suggested in previous studies. Contradictory results regarding specific cognitive domains have been reported. The aim for this study was to investigate the association between kidney function and specific cognitive domains.
In this cross-sectional design, data from the general population based cohort study "Good aging in Skåne" (GÅS) was used. The sample included 2931 subjects ages 60 to 93 randomly selected from the southern part of Sweden. Estimated glomerular filtration rate (eGFR) for both creatinine and cystatine C was calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) equation. The subjects underwent a test battery of neuropsychological tests assessing global cognitive function, learning and memory, language, complex attention, executive function, perceptual motor and meta-memory. Adjustments were made for age, sex, education and country of origin.
After adjustment for demographic variables, impaired kidney function was associated with 0.41 points worse result in MMSE, 0.56 points worse result in recognition, 0.66 points worse result in word fluency, 0.45 points worse result in digit cancellation, 0.99 points worse result in pattern comparison, and 3.71 s longer time to finish TMT B-A. Associations to cognitive function was also noted for mildly impaired kidney function defined as eGFR 45- < 60 ml/min/1,73m. No association was found between kidney function and meta-memory.
Impaired kidney function as well as the severity of impaired kidney function is associated with impairment in learning and memory, language, complex attention, executive function and global cognitive function, but not meta-memory.
之前的研究表明,肾功能受损和认知功能障碍之间可能存在血管基础上的联系。关于特定认知领域的结果存在矛盾。本研究旨在探讨肾功能与特定认知领域之间的关系。
在这项横断面设计中,我们使用了基于一般人群的斯科讷老龄化研究(GÅS)的队列研究数据。该样本包括 2931 名年龄在 60 至 93 岁之间的受试者,他们是从瑞典南部随机挑选的。使用慢性肾脏病流行病学合作组(CKD-EPI)方程计算肌酐和胱抑素 C 的估计肾小球滤过率(eGFR)。受试者接受了一系列神经心理学测试,评估了整体认知功能、学习和记忆、语言、复杂注意力、执行功能、知觉运动和元记忆。调整了年龄、性别、教育程度和原籍国等因素。
在调整了人口统计学变量后,肾功能受损与 MMSE 得分降低 0.41 分、认知得分降低 0.56 分、词汇流畅性得分降低 0.66 分、数字删除得分降低 0.45 分、模式比较得分降低 0.99 分以及 TMT B-A 测试时间延长 3.71 秒有关。轻度肾功能受损(定义为 eGFR 45-<60 ml/min/1.73m)也与认知功能相关。肾功能与元记忆之间没有关联。
肾功能受损以及肾功能受损的严重程度与学习和记忆、语言、复杂注意力、执行功能和整体认知功能受损有关,但与元记忆无关。