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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
PubMed
Summary
This summary is machine-generated.

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.

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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.