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. 2023;45(2):2294147.
doi: 10.1080/0886022X.2023.2294147. Epub 2023 Dec 14.

Effect of dietary protein intake on cognitive function in the elderly with chronic kidney disease: analysis of the National Health and Nutrition Examination Survey 2011-2014

Jingda Huang  1 , Yang Yu  2 , Huimin Li  1 , Yihui Wei  3 , Mindan Sun  1
Affiliations

Effect of dietary protein intake on cognitive function in the elderly with chronic kidney disease: analysis of the National Health and Nutrition Examination Survey 2011-2014

Jingda Huang et al. Ren Fail. 2023.

Abstract

Background: Cognitive dysfunction is prevalent among the elderly diagnosed with chronic kidney disease (CKD). Low protein diets are used for retarding the progression of CKD in clinical practice. Nonetheless, the impact of dietary protein consumption on cognitive function in this population remains uncertain.

Methods: We recruited 2306 participants (≥60 years) from 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). 24-h dietary recall questionnaire was utilized to evaluate protein intake. Cognitive function was measured using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Participants' characteristics were analyzed, and the interaction between protein consumption and CKD on cognitive impairment were analyzed using a logistic regression model.

Results: We divided participants into three groups based on CKD stages: no CKD, CKD stage G1 to G2 (19%), and CKD stage G3 to G5 (18%). The average protein intake was 0.97 g/(kg·d). In the higher protein intake group, CKD stages G1 to G2 elevated the risk of immediate memory impairment (OR: 2.441, 95% Cl: 1.161-5.132 for protein consumption in 1.0-1.2g/(kg·d); OR: 2.225, 95% Cl: 1.015-4.876 for protein consumption in >1.2 g/(kg·d)). However, no similar resuts were observed in the lower protein intake group. In addition, the interaction between CKD status and protein intake on immediate memory was statistically significant (p = .041).

Conclusion: A higher probability of cognitive impairment in the elderly with early-stage CKD may be linked to higher protein intake. Low protein diets may be a potential strategy to release cognitive impairment in the elderly with early-stage CKD.

Keywords: Dietary protein intake; NHANES; chronic kidney disease; cognitive function; elderly.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1.
Figure 1.
Flow chart of the screening process for the selection of eligible participants.
Figure 2.
Figure 2.
Cognitive function test scores by CKD stage among participants ≥60 years old from the NHANES (2011–2014) (overall (N = 2306); non-CKD (N = 1458); CKD stage G1-G2 (N = 433); CKD stage G3-G5 (N = 415)).
See this image and copyright information in PMC

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