老年人的 eGFR 轻度至中度下降与认知能力下降。
Mild to moderate decrease in eGFR and cognitive decline in older adults.
机构信息
University of Kansas School of Medicine, Kansas City, KS, USA.
Kansas City Veterans Affairs, Kansas City, KS, USA.
出版信息
Nephrol Dial Transplant. 2022 Jul 26;37(8):1499-1506. doi: 10.1093/ndt/gfab226.
BACKGROUND
Whether mild to moderately low estimated glomerular filtration rate (eGFR) is associated with cognitive decline in older adults is not clear. We evaluated changes in cognition in relation to baseline eGFR in older adults participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI).
METHODS
This is a longitudinal secondary analysis of an established observational cohort. We used data from the ADNI, an National Institutes of Health-funded, multicenter longitudinal observational study that includes participants with and without cognitive impairment who were administered a comprehensive battery of neuropsychological tests every 6 months. We related the Chronic Kidney Disease Epidemiology Collaboration eGFR with previously validated cognition composite scores for memory (ADNI-Mem) and executive function (ADNI-EF) in multivariable linear regression analysis adjusted for age, sex, race and level of education.
RESULTS
A total of 1127 ADNI participants (mean age 74 ± 7 years, 57% men, 97% Caucasian, mean follow-up 6 ± 2.6 years) were included in the analysis. The mean baseline eGFR was 76 ± 19 mL/min/1.73 m2, with 6% with eGFR <45, 22% with eGFR 45-<60, 51% with eGFR 60-90 and 21% with eGFR >90 mL/min/1.73 m2 at baseline. Both ADNI-Mem and ADNI-EF scores declined over time. In the multivariable linear regression model, older age (β = -0.117, P = 0.01), female sex (β = 0.312, P < 0.001) and lower education (β = 0.079, P < 0.001) were associated with a decline in ADNI-Mem scores, whereas baseline eGFR (each 10 mL/min/1.73 m2 change) was not {β = -0.03 [confidence interval (CI) -0.06-0.001], P = 0.11}. Similarly, older age (β = -0.278, P < 0.001) and lower education (β = 0.099, P < 0.001) were associated with a decline in ADNI-EF scores, whereas baseline eGFR was not [β = 0.004 (95% CI -0.04-0.04), P = 0.84].
CONCLUSIONS
In this cohort from the ADNI study, there was no association between baseline eGFR and cognitive decline in older adults with mild to moderately low eGFR.
背景
轻度至中度低估计肾小球滤过率（eGFR）是否与老年人认知能力下降有关尚不清楚。我们评估了在参与阿尔茨海默病神经影像学倡议（ADNI）的老年人中，基线 eGFR 与认知变化的关系。
方法
这是对既定观察队列的纵向二次分析。我们使用了 ADNI 的数据，ADNI 是由美国国立卫生研究院资助的多中心纵向观察研究，包括有和没有认知障碍的参与者，他们每 6 个月接受一次全面的神经心理测试。我们在多变量线性回归分析中，将慢性肾脏病流行病学合作 eGFR 与先前验证的记忆认知综合评分（ADNI-Mem）和执行功能评分（ADNI-EF）相关联，调整了年龄、性别、种族和教育水平。
结果
共有 1127 名 ADNI 参与者（平均年龄 74 ± 7 岁，57%为男性，97%为白种人，平均随访 6 ± 2.6 年）纳入分析。基线 eGFR 的平均值为 76 ± 19 mL/min/1.73 m2，6%的患者 eGFR <45，22%的患者 eGFR 45-<60，51%的患者 eGFR 60-90，21%的患者 eGFR >90 mL/min/1.73 m2。ADNI-Mem 和 ADNI-EF 评分均随时间下降。在多变量线性回归模型中，年龄较大（β = -0.117，P = 0.01）、女性（β = 0.312，P < 0.001）和教育程度较低（β = 0.079，P < 0.001）与 ADNI-Mem 评分下降相关，而基线 eGFR（每 10 mL/min/1.73 m2 变化）则无关联（β = -0.03 [95%置信区间（CI）-0.06-0.001]，P = 0.11）。同样，年龄较大（β = -0.278，P < 0.001）和教育程度较低（β = 0.099，P < 0.001）与 ADNI-EF 评分下降相关，而基线 eGFR 则无关联[β = 0.004（95%CI -0.04-0.04），P = 0.84]。
结论
在 ADNI 研究的这个队列中，在轻度至中度低 eGFR 的老年人中，基线 eGFR 与认知能力下降之间没有关联。
Zotero 插件