title: Association Between Cognitive Impairment and Chronic Kidney Disease in Mexican Americans.
abstract: OBJECTIVE
  To analyze the association between chronic kidney disease (CKD) and mild cognitive impairment (MCI) in Mexican Americans and to determine whether there is a blood-based proteomic profile linking CKD to MCI.
  
  
  METHODS
  Retrospective analysis of cohort study.
  
  
  METHODS
  Health and Aging Brain among Latino Elders study.
  
  
  METHODS
  Mexican Americans (N = 437, 105 men, 332 women).
  
  
  METHODS
  Data were analyzed to examine the link between estimated glomerular filtration rate (eGFR) and detailed neuropsychological functioning. Serum proteomic markers were also examined.
  
  
  RESULTS
  Lower eGFR levels were associated with significantly poorer neuropsychological functioning across multiple domains. After adjusting for age, sex, education, and diabetes mellitus, participants with an eGFR less than 45 mL/min per 1.73 m(2) performed significantly worse than those with an eGFR from 45 to 59 mL/min per 1.73 m(2) or 60 mL/min per 1.73 m(2) and higher in processing speed (F = 14.1, P < .001), executive functioning (F = 4.5, P = .01), visuospatial skills (F = 4.8, P = .009), and global cognitive functioning (F = 6.2, P = .002). Participants with an eGFR less than 45 mL/min per 1.73 m(2) also performed significantly worse than those with an eGFR of 60 mL/min per 1.73 m(2) or greater on delayed memory (F = 3.8, P = .02). There was a trend toward lower eGFR levels being associated with greater risk of MCI (odds ratio (OR) = 2.4, 95% confidence interval (CI) = 0.91-6.1, P = .07), which was stronger for men (OR = 9.6, 95% CI = 1.3-74.3, P = .03). A serum proteomic profile consisting of Factor VII, interleukin-10, C-reactive protein, and fatty acid binding protein was 93% accurate in detecting CKD-related MCI.
  
  
  CONCLUSIONS
  Lower eGFR was associated with significantly poorer neuropsychological functioning in Mexican Americans. A blood-based profile was generated that was highly accurate in detecting CKD-related MCI. A blood profile capable of predicting CKD-related cognitive impairment would be of benefit for the design of clinical interventions.
authors.affiliation: Department of Internal Medicine, University of North Texas, Fort Worth, Texas.|Division of Nephrology, Baylor University Medical Center, Dallas, Texas.
authors.forename: Harold M
authors.initials: HM
authors.lastname: Szerlip
authors.affiliation: Department of Internal Medicine, University of North Texas, Fort Worth, Texas.|Department of Psychology, University of North Texas, Fort Worth, Texas.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Edwards
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Williams
authors.affiliation: Department of Internal Medicine, University of North Texas, Fort Worth, Texas.|Institute for Aging and Alzheimer's Disease Research, Health Sciences Center, University of North Texas, Fort Worth, Texas.
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Johnson
authors.affiliation: Department of Internal Medicine, University of North Texas, Fort Worth, Texas.
authors.forename: Raul M
authors.initials: RM
authors.lastname: Vintimilla
authors.affiliation: Department of Internal Medicine, University of North Texas, Fort Worth, Texas.|Institute for Aging and Alzheimer's Disease Research, Health Sciences Center, University of North Texas, Fort Worth, Texas.
authors.forename: Sid E
authors.initials: SE
authors.lastname: O'Bryant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D005167:Factor VII / Q000032:analysis; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D009483:Neuropsychological Tests; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D016753:Interleukin-10; D005167:Factor VII; D002097:C-Reactive Protein
keywords: Mexican Americans; chronic kidney disease; cognitive impairment; neuropsychological testing; proteomics