Association between eGFR and Disability-Free Survival in Older Adults Varies by Physical Function

Area of Science:

• Gerontology
• Nephrology
• Biomarkers

Background:

• Interpreting reduced estimated glomerular filtration rate (eGFR) in older adults is complex due to potential muscle mass influences on creatinine levels.
• Gait speed and grip strength, as indicators of muscle mass, were examined for their role in understanding eGFR's clinical relevance.

Purpose of the Study:

• To investigate if gait speed and grip strength can aid in interpreting the association between eGFR and disability-free survival in older adults.
• To determine the clinical utility of muscle strength and function markers alongside eGFR in predicting health outcomes.

Main Methods:

• A cohort study utilizing data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and its follow-up.
• Analysis involved baseline eGFR categories combined with gait speed (m/s) and grip strength (weak vs. not weak).
• Outcomes assessed included disability-free survival, all-cause mortality, physical disability, and dementia.

Main Results:

• In 16,925 participants, eGFR <60 mL/min/1.73m2 did not elevate risk for disability-free survival if gait speed and grip strength were normal.
• Slow gait or weak grip, irrespective of eGFR level, correlated with reduced disability-free survival, increased mortality, and greater disability.
• Participants with eGFR ≥80 mL/min/1.73m2 and slow gait showed an increased risk for dementia (HR: 1.48).

Conclusions:

• Gait speed and grip strength assessments offer valuable context for interpreting the relationship between eGFR and disability-free survival in healthy older adults.
• These physical function measures can enhance the understanding of eGFR's impact on various health outcomes, including mortality and cognitive decline.