title: Severe Decline of Estimated Glomerular Filtration Rate Associates with Progressive Cognitive Deterioration in the Elderly: A Community-Based Cohort Study.
abstract: Cognitive dysfunction is closely related to aging and chronic kidney disease (CKD). However, the association between renal function changes and the risk of developing cognitive impairment has not been elucidated. This longitudinal cohort study was to determine the influence of annual percentage change in estimated glomerular filtration rate (eGFR) on subsequent cognitive deterioration or death of the elderly within the community. A total of 33,654 elders with eGFR measurements were extracted from the Taipei City Elderly Health Examination Database. The Short Portable Mental Status Questionnaire was used to assess their cognitive progression at least twice during follow-up visits. Multivariable Cox regression models were used to estimate the hazard ratio (HR) for cognitive deterioration or all-cause mortality with the percentage change in eGFR. During a median follow-up of 5.4 years, the participants with severe decline in eGFR (>20% per year) had an increased risk of cognitive deterioration (HR, 1.33; 95% confidence interval [CI], 1.08-1.72) and the composite outcome (HR, 1.17; 95% CI, 1.03-1.35) when compared with those who had stable eGFR. Severe eGFR decline could be a possible predictor for cognitive deterioration or death among the elderly. Early detection of severe eGFR decline is a critical issue and needs clinical attentions.
authors.affiliation: Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yi-Chi
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Center for Geriatrics and Gerontology, Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Shuo-Chun
authors.initials: SC
authors.lastname: Weng
authors.affiliation: Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
authors.forename: Jia-Sin
authors.initials: JS
authors.lastname: Liu
authors.affiliation: Institute of Clinical Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Han-Lin
authors.initials: HL
authors.lastname: Chuang
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.|Department of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsu
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Department and Institutes of Physiology, National Yang-Ming University, Taipei, Taiwan.|Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Der-Cherng
authors.initials: DC
authors.lastname: Tarng
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology / Q000523:psychology*; D003071:Cognition / Q000502:physiology; D060825:Cognitive Dysfunction / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000523:psychology*; D003404:Creatinine / Q000097:blood; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D000073216:Mental Status and Dementia Tests; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000523:psychology*; D016019:Survival Analysis
chemical_list: D003404:Creatinine