Frail hypertensive older adults with prediabetes and chronic kidney disease: insights on organ damage and cognitive...

Area of Science:

• Gerontology
• Nephrology
• Neurology

Background:

• Hypertension and chronic kidney disease (CKD) are significant public health issues with shared mechanisms.
• Prediabetes, hypertension, and CKD increase frailty and cardiovascular risks.
• Albuminuria, a marker of kidney damage, is associated with frailty and cognitive decline in older adults.

Purpose of the Study:

• To explore the association between albuminuria and cognitive impairment in frail older adults with prediabetes and CKD.
• To assess cognitive function in relation to estimated glomerular filtration rate (eGFR) in this population.

Main Methods:

• A study of frail older patients (age > 65) with hypertension, prediabetes, CKD, and cognitive impairment (MoCA score < 26).
• Patients were recruited from March 2021 to March 2023, with a three-month follow-up.
• Inclusion criteria specified CKD with eGFR > 15 ml/min.

Main Results:

• A significant inverse correlation was found between albuminuria and Montreal Cognitive Assessment (MoCA) scores (r: 0.8846; p < 0.0001).
• Cognitive scores significantly differed based on eGFR levels (p < 0.0001).
• Multivariable regression analysis supported these findings, with albuminuria as the dependent variable.

Conclusions:

• This study is the first to demonstrate a significant link between albuminuria and eGFR with cognitive function in frail, hypertensive older adults with prediabetes and CKD.
• Albuminuria and reduced eGFR are associated with cognitive impairment in this vulnerable patient group.