title: The association between kidney function and cognitive decline in community-dwelling, elderly Japanese people.
abstract: OBJECTIVE
  The aim of this study was to evaluate the relationship between chronic kidney disease (CKD) and cognitive decline in community-dwelling older adults without dementia.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Obu Study of Health Promotion for the Elderly in Japan.
  
  
  METHODS
  The participants were 4686 residents (community-dwelling older adults without dementia) who completed baseline assessments.
  
  
  METHODS
  The estimated glomerular filtration rate (eGFR, mL/min/1.73 m(2)) was determined according to the creatinine level, and participants were classified into three mutually exclusive categories: normal (≥60.0 mL/min/1.73 m(2)), mild CKD (45.0-59.9 mL/min/1.73 m(2)), or moderate to severe CKD (<45.0 mL/min/1.73 m(2)). Cognitive function was assessed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Multivariate logistic regression was used to examine the relationships between eGFR and cognitive decline.
  
  
  RESULTS
  After multivariate adjustment, participants with lower eGFR had lower cognitive function scores on most domains (P < .05). In particular, participants with advanced CKD (eGFR <45 mL/min/1.73 m(2)) were more likely to have significant cognitive decline on the Trail Making Test part A (odds ratio = 2.347, 95% confidence interval = 1.525-3.614) and the Symbol Digit Substitution Task (odds ratio = 2.308, 95% confidence interval = 1.486-3.585) than those with normal and mild CKD.
  
  
  CONCLUSIONS
  A lower level of kidney function was associated with lower cognitive performance in attention and processing speed. These results suggest that eGFR might be an effective method to screen for cognitive decline in community-dwelling older adults.
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan. Electronic address: leesuykr@gmail.com.
authors: SungChul
authors: S
authors: Lee
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Hiroyuki
authors: H
authors: Shimada
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Hyuntae
authors: H
authors: Park
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Hyuma
authors: H
authors: Makizako
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Sangyoon
authors: S
authors: Lee
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
authors: Takehiko
authors: T
authors: Doi
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Daisuke
authors: D
authors: Yoshida
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Kota
authors: K
authors: Tsutsumimoto
authors: Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Yuya
authors: Y
authors: Anan
authors: Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
authors: Takao
authors: T
authors: Suzuki
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D057187:Independent Living; D007564:Japan; D007677:Kidney Function Tests; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis
keywords: Chronic kidney disease; creatinine; decline in cognitive function