Albuminuria and dementia in the elderly: a community study.
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.


METHODS
Cross-sectional analysis.


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


METHODS
Doubling of albuminuria.


RESULTS
Dementia defined according to neuropsychological and clinical evaluation.


METHODS
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.


CONCLUSIONS
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.
Barzilay
Joshua I
JI
Kaiser Permanente of Georgia, Tucker, GA 30084, USA. joshua.barzilay@kp.org
Fitzpatrick
Annette L
AL
Luchsinger
Jose
J
Yasar
Sevil
S
Bernick
Charles
C
Jenny
Nancy S
NS
Kuller
Lewis H
LH
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000150:complications* / Q000453:epidemiology / Q000652:urine; D001921:Brain / Q000473:pathology; D003071:Cognition / Q000502:physiology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D016017:Odds Ratio; D011159:Population Surveillance / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors