2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Seliger, S. L. Articles by Kuller, L. H. Search for Related Content PubMed PubMed Citation Articles by Seliger, S. L. Articles by Kuller, L. H.

Moderate Renal Impairment and Risk of Dementia among Older Adults: The Cardiovascular Health Cognition Study

Stephen L. Seliger^*, David S. Siscovick^,, Catherine O. Stehman-Breen^*, Daniel L. Gillen, Annette Fitzpatrick, Anthony Bleyer^¶ and Lew H. Kuller^#

*Division of Nephrology and Departments of Epidemiology, Medicine, and Biostatistics, University of Washington, Seattle, Washington; ^¶Wake Forest University School of Medicine, Winston-Salem, North Carolina; and ^#Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.

Correspondence to Dr. Stephen Seliger, Division of Nephrology, Box 356521, 1959 NE Pacific St., University of Washington, Seattle, WA 98195. Phone: (206)277-4807; Fax: (206)685-8661; E-mail: seliger{at}u.washington.edu

ABSTRACT. Renal impairment is associated with an increased risk of carotid atherosclerosis and stroke, determinants of cognitive dysfunction and dementia. The purpose of this study was to determine whether moderate renal impairment is associated with incident dementia among community-dwelling older adults. Participants in the Cardiovascular Health Cognition Study without prevalent dementia (n = 3349) were included in the analysis. Incident dementia was confirmed through neurologic testing. Renal function at baseline was estimated by the inverse of serum creatinine (1/SCr); moderate renal impairment was defined as SCr 1.3 mg/dl for women and 1.5 mg/dl for men. Cox regression models were used to estimate the association of renal impairment with incident dementia. Because SCr is also a function of muscle mass, the authors determined whether the relationship between SCr and dementia was particularly strong among individuals without severe co-morbidity at baseline, as reflected by self-reported general health status. There were 477 incident dementia cases over a median 6 yr follow-up. After adjustment for potential confounders, moderate renal insufficiency was associated with a 37% increased risk of dementia (95% CI = 1.06 to 1.78). Similarly, a 0.5-unit decrement in 1/SCr (equivalent to an increase in SCr from 1.0 to 2.0 mg/dl) was associated with a 26% increased risk (95% CI = 1.02 to 1.60). These associations were present only among the 84% of older adults who reported good–excellent health. Among those in good–excellent health, higher SCr was associated with vascular-type dementia but not Alzheimer-type dementia. Moderate renal impairment, reflected by a higher SCr, is associated with an excess risk of incident dementia among individuals in good–excellent health. Strategies to prevent or delay the onset of dementia in patients with moderate renal impairment are needed.

This article has been cited by other articles:

				J. L. Carter, S. E. O'Riordan, G. L. Eaglestone, M. P. Delaney, and E. J. Lamb Chronic kidney disease prevalence in a UK residential care home population Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1257 - 1264. [Abstract] [Full Text] [PDF]

				S. L. Seliger and W.T. Longstreth Jr Lessons About Brain Vascular Disease From Another Pulsating Organ, the Kidney Stroke, January 1, 2008; 39(1): 5 - 6. [Full Text] [PDF]

				S. Khella and M. B. Bleicher Stroke and Its Prevention in Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., November 1, 2007; 2(6): 1343 - 1351. [Abstract] [Full Text] [PDF]

				S. M. Hailpern, M. L. Melamed, H. W. Cohen, and T. H. Hostetter Moderate Chronic Kidney Disease and Cognitive Function in Adults 20 to 59 Years of Age: Third National Health and Nutrition Examination Survey (NHANES III) J. Am. Soc. Nephrol., July 1, 2007; 18(7): 2205 - 2213. [Abstract] [Full Text] [PDF]

				L. Munang, J. M. Starr, L. Whalley, and I. J. Deary Renal function and cognition in the 1932 Scottish Mental Survey Lothian cohort Age Ageing, May 1, 2007; 36(3): 323 - 325. [Full Text] [PDF]

				D. A. Rakowski, S. Caillard, L. Y. Agodoa, and K. C. Abbott Dementia as a Predictor of Mortality in Dialysis Patients Clin. J. Am. Soc. Nephrol., September 1, 2006; 1(5): 1000 - 1005. [Abstract] [Full Text] [PDF]

				A. M. Murray, D. E. Tupper, D. S. Knopman, D. T. Gilbertson, S. L. Pederson, S. Li, G. E. Smith, A. K. Hochhalter, A. J. Collins, and R. L. Kane Cognitive impairment in hemodialysis patients is common. Neurology, July 25, 2006; 67(2): 216 - 223. [Abstract] [Full Text] [PDF]

				M. Kurella, G. M. Chertow, L. F. Fried, S. R. Cummings, T. Harris, E. Simonsick, S. Satterfield, H. Ayonayon, and K. Yaffe Chronic Kidney Disease and Cognitive Impairment in the Elderly: The Health, Aging, and Body Composition Study J. Am. Soc. Nephrol., July 1, 2005; 16(7): 2127 - 2133. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673