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Kidney Function and Cognitive Health in Older Adults: The Cardiovascular Health Study Public Deposited

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  • Recent evidence has demonstrated the importance of kidney function in healthy aging. We examined the association between kidney function and change in cognitive function in 3,907 participants in the Cardiovascular Health Study, recruited from 4 U.S. communities, and studied from 1992 - 1999. Kidney function was measured by cystatin C-based estimated glomerular filtration rate (eGFR[subscript cys]). Cognitive function was assessed using the Modified Mini-Mental State Exam and the Digit Symbol Substitution Test administered up to 7 times during annual visits. There was an association between eGFR[subscript cys] and change in cognitive function after adjustment for confounders; persons with eGFR[subscript cys] < 60 ml/min/1.73m² had a 0.64 (95% confidence interval: 0.51, 0.77) point/year faster decline in Modified Mini-Mental State Exam score and a 0.42 (95% confidence interval: 0.28, 0.56) point/year faster decline in Digit Symbol Substitution Test score compared with persons with eGFR[subscript cys] ≥ 90 ml/min/1.73m². Additional adjustment for intermediate cardiovascular events modestly impacted these associations. Participants with eGFR[subscript cys] < 60 ml/min/1.73m² had fewer cognitive impairment-free life-years on average compared with those with eGFR[subscript cys] ≥ 90 ml/min/1.73m², independent of confounders and mediating cardiovascular events (-0.44, 95% confidence interval: -0.62, -0.26). Older adults with reduced kidney function are at increased risk of worsening cognitive function.
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  • Darsie, B., Shlipak, M. G., Sarnak, M. J., Katz, R., Fitzpatrick, A. L., & Odden, M. C. (2014). Kidney Function and Cognitive Health in Older Adults: The Cardiovascular Health Study. American Journal of Epidemiology, 180(1), 68-75. doi:10.1093/aje/kwu102
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  • This research was supported by the National Heart, Lung, and Blood Institute (contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, and N01HC85086, and grant HL080295), with additional contribution from the National Institute of Neurological Disorders and Stroke. Additional support was provided by the National Institute on Aging (grants R01AG023629 and R01AG027002). A full list of principal Cardiovascular Health Study investigators and institutions can be found at http://www.chs-nhlbi.org/PI.htm. M.C.O. is supported by the American Heart Association Western States Affiliate (grant 11CRP7210088) and the National Institute on Aging (grant K01AG039387).
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