Kidney disease and cognitive function: African American-diabetes heart study MIND

Area of Science:

• Nephrology
• Neurology
• Endocrinology

Background:

• Albuminuria and reduced estimated glomerular filtration rate (eGFR) are associated with cognitive decline in European populations with advanced kidney disease.
• The relationship between kidney function markers and cognitive performance in African Americans (AAs) with type 2 diabetes (T2D) is less understood.

Purpose of the Study:

• To investigate the association between albuminuria (urine albumin:creatinine ratio, UACR) and eGFR with cognitive function in unrelated AAs with T2D.
• To determine if these associations persist even in the presence of mild kidney disease.

Main Methods:

• Cross-sectional analysis of 263 unrelated AAs with T2D from the African American-Diabetes Heart Study (AA-DHS) MIND.
• Cognitive function assessed using global (3MSE, MoCA), memory (RAVLT), and executive function tests (Stroop, verbal fluency, DSC).
• Multivariate models adjusted for age, gender, BMI, HbA1c, education, hypertension, and LDL cholesterol.

Main Results:

• Higher UACR was significantly associated with worse performance on global cognitive tests (3MSE, MoCA), Digit Symbol Copy (DSC), and increased Stroop test errors and time.
• Higher eGFR was associated with better performance on the Digit Symbol Copy (DSC) test.
• These associations were observed even in participants with mild kidney disease.

Conclusions:

• Albuminuria and eGFR are associated with cognitive function in African Americans with type 2 diabetes, irrespective of kidney disease severity.
• Interventions targeting kidney health are crucial for preventing cognitive decline in T2D patients well before advanced stages of nephropathy.