Association Between Cognitive Impairment and Chronic Kidney Disease in Mexican Americans

Abstract

ObjectivesTo 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.DesignRetrospective analysis of cohort study.SettingHealth and Aging Brain among Latino Elders study.ParticipantsMexican Americans (N = 437, 105 men, 332 women).MeasurementsData were analyzed to examine the link between estimated glomerular filtration rate (eGFR) and detailed neuropsychological functioning. Serum proteomic markers were also examined.ResultsLower 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 m2 performed significantly worse than those with an eGFR from 45 to 59 mL/min per 1.73 m2 or 60 mL/min per 1.73 m2 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 m2 also performed significantly worse than those with an eGFR of 60 mL/min per 1.73 m2 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.ConclusionLower 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.

A blood screening test for Alzheimer's disease

“…Samples were analyzed from the Health & Aging Brain among Latino Elders (HABLE) study, an ongoing epidemiologic study of cognitive aging among community‐dwelling Mexican Americans and non‐Hispanic whites [21,22]. The HABLE study uses a community‐based participatory research approach, which involves partnering communities to conduct studies of human disease.…”

Cognitive Impairment and Dementia in Older Adults With Chronic Kidney Disease

“…Moderate eGFR (45-59mL/min/1.73m 2 ) and high eGFR (≥60mL/min/m 2 ) were not associated with cognitive function. In the Health and Aging Brain among Latino Elders study (23), 437 Mexican Americans with low eGFR (<45 mL/min/1.73m 2 ) showed poorer global cognitive function as well as poorer processing speed, executive function, and visuospatial skills than individuals with moderate (45-59 mL/min/1.73m 2 ) or high (≥60 mL/min/1.73m 2 ) eGFR. In another study, Event Related Potentials (ERPs) were used to measure speed of cognitive processing in individuals with CKD and ESRD; the authors found significant prolongation of P3 latencies (corresponding to slower processing speed) in CKD stages 4 and 5 (17).…”

“…Although cognitive impairment is well studied in CKD, only three studies (12, 19, 23) to our knowledge have assessed MCI as an outcome. In their study, Post et al (19) studied 24 patients with CKD and 27 patients with ESRD receiving hemodialysis (HD) without any history of dementia, stroke or neurodegenerative disease.…”

“…More recently, research is moving forward to predicting which CKD participants will develop MCI based on blood samples; in the Health and Aging Brain among Latino Elders study (23), a blood-based profile that accurately predicted CKD-related MCI within 12 months of follow-up in individuals with eGFR <60ml mL/min/1.73m 2 . This is a move forward from estimating prevalence rates within the CKD spectrum.…”

Depression, inflammation, and memory loss among Mexican Americans: analysis of the HABLE cohort

“…Data from 381 participants from the Health and Aging Brain among Latino Elders (HABLE) study were analyzed (Edwards et al ., 2015 ; Johnson et al ., 2015a; Szerlip et al ., 2015 ). The HABLE study is an ongoing epidemiological study of cognitive aging among community-dwelling Mexican-American individuals.…”