Association Between Cognitive Impairment and Chronic Kidney Disease in Mexican Americans

J Am Geriatr Soc. 2015 Oct;63(10):2023-8. doi: 10.1111/jgs.13665. Epub 2015 Oct 12.

Abstract

Objectives: To analyze the association between chronic kidney disease (CKD) and mild cognitive impairment (MCI) in Mexican Americans and to determine whether there is a blood-based proteomic profile linking CKD to MCI.

Design: Retrospective analysis of cohort study.

Setting: Health and Aging Brain among Latino Elders study.

Participants: Mexican Americans (N = 437, 105 men, 332 women).

Measurements: Data were analyzed to examine the link between estimated glomerular filtration rate (eGFR) and detailed neuropsychological functioning. Serum proteomic markers were also examined.

Results: Lower eGFR levels were associated with significantly poorer neuropsychological functioning across multiple domains. After adjusting for age, sex, education, and diabetes mellitus, participants with an eGFR less than 45 mL/min per 1.73 m(2) performed significantly worse than those with an eGFR from 45 to 59 mL/min per 1.73 m(2) or 60 mL/min per 1.73 m(2) and higher in processing speed (F = 14.1, P < .001), executive functioning (F = 4.5, P = .01), visuospatial skills (F = 4.8, P = .009), and global cognitive functioning (F = 6.2, P = .002). Participants with an eGFR less than 45 mL/min per 1.73 m(2) also performed significantly worse than those with an eGFR of 60 mL/min per 1.73 m(2) or greater on delayed memory (F = 3.8, P = .02). There was a trend toward lower eGFR levels being associated with greater risk of MCI (odds ratio (OR) = 2.4, 95% confidence interval (CI) = 0.91-6.1, P = .07), which was stronger for men (OR = 9.6, 95% CI = 1.3-74.3, P = .03). A serum proteomic profile consisting of Factor VII, interleukin-10, C-reactive protein, and fatty acid binding protein was 93% accurate in detecting CKD-related MCI.

Conclusion: Lower eGFR was associated with significantly poorer neuropsychological functioning in Mexican Americans. A blood-based profile was generated that was highly accurate in detecting CKD-related MCI. A blood profile capable of predicting CKD-related cognitive impairment would be of benefit for the design of clinical interventions.

Keywords: Mexican Americans; chronic kidney disease; cognitive impairment; neuropsychological testing; proteomics.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Cohort Studies
  • Factor VII / analysis
  • Fatty Acid-Binding Proteins / blood
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Interleukin-10 / blood
  • Male
  • Mexican Americans*
  • Middle Aged
  • Neuropsychological Tests
  • Renal Insufficiency, Chronic / epidemiology*
  • Retrospective Studies
  • Sex Factors
  • United States / epidemiology

Substances

  • Biomarkers
  • Fatty Acid-Binding Proteins
  • Interleukin-10
  • Factor VII
  • C-Reactive Protein