Serum phosphate and cognitive function in older men.
OBJECTIVE
Determine whether serum phosphate is associated with concurrent cognitive impairment and subsequent cognitive decline in older men independent of demographic covariates and atherosclerotic risk factors.


METHODS
In a prospective study of 5529 men enrolled in the Osteoporotic Fractures in Men study, we measured baseline serum phosphate, baseline cognitive function, and change in cognitive function between baseline and follow-up exams an average of 4.6 years later using the Modified Mini-Mental State (3MS) Examination and Trails B.


RESULTS
There was no association between serum phosphate and odds of cognitive impairment as assessed by baseline 3MS score or risk of cognitive decline as assessed by longitudinal change in 3MS score. Higher baseline serum phosphate was associated with higher odds of poor executive function as assessed by Trails B with fully adjusted odds ratios 1.12 (95% confidence interval: 0.83-1.52), 1.31 (0.97-1.77), and 1.45 (1.08-1.94) for men in the second, third, and fourth versus the bottom quartile (referent group) of serum phosphate (p-trend 0.007). However, higher phosphate level was not associated with risk of decline in executive function as assessed by longitudinal change in Trails B score with fully adjusted odds ratios 0.94 (95% confidence interval 0.69-1.28), 0.96 (0.70-1.32), and 1.21 (0.89-1.66) for men in the second, third, and fourth versus the bottom quartile (referent group) of serum phosphate (p-trend 0.22).


CONCLUSIONS
Higher serum phosphate in older men was associated with a higher likelihood of poor executive function, but not with impaired global cognitive function or decline in executive or global cognition. Copyright © 2017 John Wiley & Sons, Ltd.
Department of Nephrology, VA Health Care System, Minneapolis, MN, USA.|Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Yelena
http://orcid.org/0000-0001-5661-0260
Y
Slinin
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
Tien
T
Vo
Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.|Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN, USA.
Brent C
BC
Taylor
Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|Department of Medicine, Geriatrics Division, Hennepin County Medical Center, Minneapolis, MN, USA.
Anne M
AM
Murray
HealthPartners Institute, Bloomington, MN, USA.|Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
John
J
Schousboe
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
Lisa
L
Langsetmo
Department of Medicine, University of Minnesota, Minneapolis, MN, USA.|Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.|Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN, USA.
Kristine
K
Ensrud
D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000097:blood* / Q000503:physiopathology; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010710:Phosphates / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors
D010710:Phosphates
cognitive function; men; older; phosphate