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不同西班牙裔/拉丁裔个体的肾功能与认知衰老及损害:拉丁裔神经认知衰老调查研究(HCHS/SOL)

Kidney function and cognitive aging and impairment among diverse Hispanic/Latino individuals: Study of Latinos-Investigation of Neurocognitive Aging (HCHS/SOL).

作者信息

González Hector M, Kuwayama Sayaka, Anita Natasha, Galasko Douglas, Márquez Freddie, Stickel Ariana M, Daviglus Martha, Elfassy Tali, Johns Tanya, Lash James, Franceschini Nora, Tarraf Wassim

机构信息

Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, La Jolla, California, USA.

Department of Psychology, San Diego State University, San Diego, California, USA.

出版信息

Alzheimers Dement. 2025 May;21(5):e70301. doi: 10.1002/alz.70301.

Abstract

INTRODUCTION

The purpose of this study is to examine associations between kidney disease and cognitive impairment among diverse middle-aged and older Hispanic/Latino individuals.

METHODS

Between 2016 and 2018, the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) enrolled diverse Hispanic/Latino individuals ages 50 years and older (n = 6377). Cognitive function, cognitive change, and mild cognitive impairment (MCI) were the primary outcomes. Chronic kidney disease (CKD, defined as estimated glomerular filtration rate [eGFR] < 60 mL/min per 1.73 m2 or urine albumin-creatinine ratio [uACR] ≥ 30 mg/g) and two independent secondary exposures (i.e., eGFR and uACR) were examined.

RESULTS

CKD was associated with lower cognitive function and 7-year cognitive decline independent of diabetes and hypertension. CKD was associated with MCI, but the effect attenuated by adjustments for CVD risk factors. More albuminuria was associated with lower cognitive function, cognitive decline, independent of CVD risk factors.

DISCUSSION

CKD and higher albuminuria were linked to lower cognitive function, cognitive decline, and elevated risk for MCI among diverse middle-aged and older Hispanic/Latino individuals.

HIGHLIGHTS

Kidney disease has garnered increased attention in interpreting blood-based biomarkers of Alzheimer's disease and related disorders. Hispanic/Latino individuals are at increased risk for kidney disease. We found that urinary albumin-to-creatinine ratio outperformed estimated glomerular filtration in relation to cognitive function and impairment. Our findings suggest that kidney dysfunction is an independent marker of cognitive function and impairment.

摘要

引言

本研究旨在探讨不同年龄段的西班牙裔/拉丁裔中老年人肾病与认知障碍之间的关联。

方法

2016年至2018年间,拉丁裔神经认知衰老研究(SOL-INCA)招募了6377名50岁及以上的不同西班牙裔/拉丁裔个体。认知功能、认知变化和轻度认知障碍(MCI)是主要研究结果。研究考察了慢性肾脏病(CKD,定义为估算肾小球滤过率[eGFR]<60ml/min/1.73m²或尿白蛋白肌酐比值[uACR]≥30mg/g)以及两个独立的次要暴露因素(即eGFR和uACR)。

结果

CKD与较低的认知功能及7年认知衰退相关,且独立于糖尿病和高血压。CKD与MCI相关,但在对心血管疾病危险因素进行调整后,这种影响减弱。更多的蛋白尿与较低的认知功能、认知衰退相关,且独立于心血管疾病危险因素。

讨论

在不同年龄段的西班牙裔/拉丁裔中老年人中,CKD和较高的蛋白尿与较低的认知功能、认知衰退以及MCI风险升高有关。

要点

在解释阿尔茨海默病及相关疾病的血液生物标志物时,肾病受到了越来越多的关注。西班牙裔/拉丁裔个体患肾病的风险增加。我们发现,就认知功能和障碍而言,尿白蛋白肌酐比值优于估算肾小球滤过率。我们的研究结果表明,肾功能不全是认知功能和障碍的一个独立标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/182f/12102662/8fcc2ae1068d/ALZ-21-e70301-g001.jpg

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