Association between renal function and cognitive ability domains in the Einstein aging study: a cross-sectional analysis

Andrea R. Zammit, Mindy Joy Katz, Jennifer Y. Lai, Molly E. Zimmerman, Markus Bitzer, Richard B. Lipton

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: The relationships between renal function and specific domains of cognitive function have rarely been explored in representative, community-based samples of older adults. We assessed the association between renal and cognitive function based on an extensive battery of neurocognitive tests.

METHODS: In a sample of Einstein Aging Study participants (n = 649, age = 70+ years) we calculated estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration formula. We predefined three groups based on eGFR units of mL/min/1.73 m(2) as low (<45), medium (45-59), and high (≥60). Thirteen neurocognitive tests were subjected to principle component analysis revealing three components: a global component, an episodic memory component, and a frontal-executive component. We first examined the relationship of eGFR group to cognitive performance in each domain and then examined subtests for the domains which proved to be statistically significant.

RESULTS: The sample (mean = 79.2, 61% = female) was distributed among eGFR categories as follows: low (n = 67), medium (n = 151), and high (n = 431). The frontal-executive domain was significantly associated with poor cognitive performance in the low eGFR group (p <.001). When we examined the neuropsychological test components for frontal-executive domain, performance was lower on two of four contributing tests (Trail Making Test Part B and the Digit Symbol Substitution test). Other domains of cognitive function were not associated with eGFR.

CONCLUSIONS: Low eGFR is associated with reduced performance on executive function. Individuals with poor renal function should be assessed for cognitive impairment. Potential mechanisms are discussed.

Original languageEnglish (US)
Pages (from-to)764-770
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume70
Issue number6
DOIs
StatePublished - Jun 1 2015

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Aptitude
Glomerular Filtration Rate
Cognition
Cross-Sectional Studies
Kidney
Trail Making Test
Episodic Memory
Neuropsychological Tests
Executive Function
Chronic Renal Insufficiency
Epidemiology

Keywords

  • Cognition
  • Executive function.
  • Renal function

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Association between renal function and cognitive ability domains in the Einstein aging study: a cross-sectional analysis",
abstract = "BACKGROUND: The relationships between renal function and specific domains of cognitive function have rarely been explored in representative, community-based samples of older adults. We assessed the association between renal and cognitive function based on an extensive battery of neurocognitive tests.METHODS: In a sample of Einstein Aging Study participants (n = 649, age = 70+ years) we calculated estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration formula. We predefined three groups based on eGFR units of mL/min/1.73 m(2) as low (<45), medium (45-59), and high (≥60). Thirteen neurocognitive tests were subjected to principle component analysis revealing three components: a global component, an episodic memory component, and a frontal-executive component. We first examined the relationship of eGFR group to cognitive performance in each domain and then examined subtests for the domains which proved to be statistically significant.RESULTS: The sample (mean = 79.2, 61{\%} = female) was distributed among eGFR categories as follows: low (n = 67), medium (n = 151), and high (n = 431). The frontal-executive domain was significantly associated with poor cognitive performance in the low eGFR group (p <.001). When we examined the neuropsychological test components for frontal-executive domain, performance was lower on two of four contributing tests (Trail Making Test Part B and the Digit Symbol Substitution test). Other domains of cognitive function were not associated with eGFR.CONCLUSIONS: Low eGFR is associated with reduced performance on executive function. Individuals with poor renal function should be assessed for cognitive impairment. Potential mechanisms are discussed.",
keywords = "Cognition, Executive function., Renal function",
author = "Zammit, {Andrea R.} and Katz, {Mindy Joy} and Lai, {Jennifer Y.} and Zimmerman, {Molly E.} and Markus Bitzer and Lipton, {Richard B.}",
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T1 - Association between renal function and cognitive ability domains in the Einstein aging study

T2 - a cross-sectional analysis

AU - Zammit, Andrea R.

AU - Katz, Mindy Joy

AU - Lai, Jennifer Y.

AU - Zimmerman, Molly E.

AU - Bitzer, Markus

AU - Lipton, Richard B.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - BACKGROUND: The relationships between renal function and specific domains of cognitive function have rarely been explored in representative, community-based samples of older adults. We assessed the association between renal and cognitive function based on an extensive battery of neurocognitive tests.METHODS: In a sample of Einstein Aging Study participants (n = 649, age = 70+ years) we calculated estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration formula. We predefined three groups based on eGFR units of mL/min/1.73 m(2) as low (<45), medium (45-59), and high (≥60). Thirteen neurocognitive tests were subjected to principle component analysis revealing three components: a global component, an episodic memory component, and a frontal-executive component. We first examined the relationship of eGFR group to cognitive performance in each domain and then examined subtests for the domains which proved to be statistically significant.RESULTS: The sample (mean = 79.2, 61% = female) was distributed among eGFR categories as follows: low (n = 67), medium (n = 151), and high (n = 431). The frontal-executive domain was significantly associated with poor cognitive performance in the low eGFR group (p <.001). When we examined the neuropsychological test components for frontal-executive domain, performance was lower on two of four contributing tests (Trail Making Test Part B and the Digit Symbol Substitution test). Other domains of cognitive function were not associated with eGFR.CONCLUSIONS: Low eGFR is associated with reduced performance on executive function. Individuals with poor renal function should be assessed for cognitive impairment. Potential mechanisms are discussed.

AB - BACKGROUND: The relationships between renal function and specific domains of cognitive function have rarely been explored in representative, community-based samples of older adults. We assessed the association between renal and cognitive function based on an extensive battery of neurocognitive tests.METHODS: In a sample of Einstein Aging Study participants (n = 649, age = 70+ years) we calculated estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration formula. We predefined three groups based on eGFR units of mL/min/1.73 m(2) as low (<45), medium (45-59), and high (≥60). Thirteen neurocognitive tests were subjected to principle component analysis revealing three components: a global component, an episodic memory component, and a frontal-executive component. We first examined the relationship of eGFR group to cognitive performance in each domain and then examined subtests for the domains which proved to be statistically significant.RESULTS: The sample (mean = 79.2, 61% = female) was distributed among eGFR categories as follows: low (n = 67), medium (n = 151), and high (n = 431). The frontal-executive domain was significantly associated with poor cognitive performance in the low eGFR group (p <.001). When we examined the neuropsychological test components for frontal-executive domain, performance was lower on two of four contributing tests (Trail Making Test Part B and the Digit Symbol Substitution test). Other domains of cognitive function were not associated with eGFR.CONCLUSIONS: Low eGFR is associated with reduced performance on executive function. Individuals with poor renal function should be assessed for cognitive impairment. Potential mechanisms are discussed.

KW - Cognition

KW - Executive function.

KW - Renal function

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