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Comparative Study
. 2008 Aug;52(2):216-26.
doi: 10.1053/j.ajkd.2007.12.044. Epub 2008 May 12.

Albuminuria and dementia in the elderly: a community study

Joshua I Barzilay  1 , Annette L Fitzpatrick, Jose Luchsinger, Sevil Yasar, Charles Bernick, Nancy S Jenny, Lewis H Kuller
Affiliations
Comparative Study

Albuminuria and dementia in the elderly: a community study

Joshua I Barzilay et al. Am J Kidney Dis. 2008 Aug.

Abstract

Background: Dementia is associated with microvascular disease of the retina. In this study, we examine whether cognitive status (normal cognition, mild cognitive impairment, and dementia) is associated with albuminuria, a microvascular disorder of the kidney.

Study design: Cross-sectional analysis.

Setting & participants: 2,316 participants from the Cardiovascular Health Cognition Study who underwent brain magnetic resonance imaging and testing for albuminuria.

Predictor: Doubling of albuminuria.

Outcome: Dementia defined according to neuropsychological and clinical evaluation.

Measurements: Multinomial logistic modeling was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of dementia and mild cognitive impairment with doubling of albuminuria compared with the odds with normal cognition.

Results: 283 participants (12.2%) had dementia, 344 (14.9%) had mild cognitive impairment, and 1,689 (72.9%) had normal cognition. Compared with participants with normal cognition, doubling of albuminuria was associated with increased odds of dementia (OR, 1.22; 95% CI, 1.15 to 1.29). Adjustment for prevalent cardiovascular disease and cardiovascular risk factors, lipid levels, C-reactive protein level, estimated glomerular filtration rate, and apolipoprotein E-4 genotype attenuated this association, but it remained statistically significant (OR, 1.12; 95% CI, 1.03 to 1.22). Mild cognitive impairment was associated with albuminuria on unadjusted analysis, but not with adjustment for other factors.

Limitations: Results are cross-sectional; causality cannot be imputed.

Conclusions: The odds of dementia increased in the presence of albuminuria. These findings suggest a role of shared susceptibility for microvascular disease in the brain and kidney in older adults.

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Figures

Figure 1
Figure 1
Time line of the Cardiovascular Health Cognition Study.
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References

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