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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Kidney dysfunction and cognitive decline in women.

Imran Sajjad1, Francine Grodstein, Jae H Kang

  • 1Renal Division, Brigham and Women's Hospital, Boston, MA 02115, USA.

Clinical Journal of the American Society of Nephrology : CJASN
|January 14, 2012
PubMed
Summary

A urinary albumin-to-creatinine ratio (ACR) ≥5 mg/g, even if not clinically significant, is linked to faster cognitive decline in older women. This finding suggests kidney function markers may predict brain health changes over time.

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Area of Science:

  • Nephrology
  • Geriatrics
  • Cognitive Neuroscience

Background:

  • End-stage renal disease (ESRD) is linked to cognitive deficits.
  • The predictive value of earlier kidney dysfunction for cognitive decline remains unclear.

Purpose of the Study:

  • To investigate the association between early kidney dysfunction markers and cognitive decline in older women.
  • To determine if estimated glomerular filtration rate (eGFR) or urinary albumin-to-creatinine ratio (ACR) predicts cognitive decline.

Main Methods:

  • 1700+ women aged ≥70 years from the Nurses' Health Study underwent cognitive testing and kidney function assessment (plasma creatinine, ACR).
  • Cognition was reassessed every 2 years for up to 6 years, covering general cognition, verbal memory, verbal fluency, and working memory.
  • Mixed-effects regression analyzed cognitive decline rates based on eGFR <60 ml/min/1.73 m² or ACR ≥5 mg/g.

Main Results:

  • A baseline ACR ≥5 mg/g was associated with 2-7 times faster decline in all four cognitive domains compared to ACR <5 mg/g.
  • The accelerated cognitive decline observed with higher ACR was equivalent to 2-7 years of aging.
  • No association was found between eGFR <60 ml/min/1.73 m² and cognitive decline.

Conclusions:

  • A baseline urinary ACR ≥5 mg/g, a level often considered subclinical, independently predicts accelerated cognitive decline.
  • Urinary ACR may serve as an early indicator of cognitive impairment risk in older adults.
  • Kidney health, specifically albuminuria, is implicated in maintaining cognitive function in aging populations.