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Published on: September 20, 2018
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Clinical Manifestations
Eunsun Gill1, Flor Alvarado2, David J Libon3,4
1Celia Scott Weatherhead Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
Summary
Declining kidney function trajectories, both high and low, are linked to poorer midlife cognitive function. Maintaining stable estimated glomerular filtration rate (eGFR) is crucial for preserving cognitive health throughout adulthood.
Area of Science:
- Nephrology
- Neurology
- Gerontology
Background:
- Estimated glomerular filtration rate (eGFR) shows a nonlinear association with cognitive function (CF).
- The long-term impact of eGFR trajectories on midlife cognitive function remains under-investigated.
- This study utilizes data from the Bogalusa Heart Study (BHS) to explore this relationship.
Purpose of the Study:
- To investigate the association between distinct eGFR trajectories throughout adulthood and cognitive function in midlife.
- To identify patterns of eGFR changes over time and their correlation with various cognitive domains.
Main Methods:
- Latent class growth analysis identified three eGFR trajectory classes from 721 BHS participants with multiple adult creatinine measurements.
- Cognitive function was assessed using tests for memory, working memory, attention, and processing speed, with global CF computed by averaging scores.
- Multivariate regression analyses adjusted for demographic and clinical factors to determine the association between eGFR trajectories and CF.
Main Results:
- Three eGFR trajectories were identified: 'high-steady downward trend' (46.7%), 'upward-to-downward trend' (28.7%), and 'low-steady downward trend' (24.4%).
- Both high-steady downward and low-steady downward eGFR trajectories were associated with significantly lower global cognitive function compared to the upward-to-downward trend.
- Specific cognitive domains, including episodic memory, working memory, attention, and graphomotor information processing speed (GIPS), were negatively impacted by both downward eGFR trends.
Conclusions:
- Both high and low steady downward trends in eGFR during adulthood are linked to diminished global cognitive function and specific cognitive domains in midlife.
- An upward-to-downward eGFR trajectory was associated with better cognitive outcomes compared to sustained downward trends.
- These findings highlight the critical role of maintaining stable renal function in preserving cognitive health across the lifespan.
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