Impacts of Kidney Dysfunction and Cerebral Cortical Thinning on Cognitive Change in Elderly Population
Journal
Journal of Alzheimer's disease : JAD
Journal Volume
76
Journal Issue
1
Pages
225-236
Date Issued
2020
Author(s)
Abstract
Background: Cerebral cortical thickness is a neuroimaging biomarker to predict cognitive decline, and kidney dysfunction (KD) is associated with cortical thinning. Objective: This study aimed to investigate the effects of KD and cortical thinning on cognitive change in a prospective cohort study. Methods: A total of 244 non-demented participants were recruited from elderly health checkup program and received cognitive exams including Montreal Cognitive Assessment (MoCA) and different cognitive domains at baseline and three biannual follow-ups afterwards. KD was defined as having either glomerular filtration rate <60 ml/min/1.73 m2 or proteinuria. Cortical thickness of global, lobar, and Alzheimer's disease (AD) signature area were derived from magnetic resonance imaging at baseline, and cortical thinning was defined as the lowest tertile of cortical thickness. Generalized linear mixed models were applied to evaluate the effects of KD and cortical thinning on cognitive changes. Results: KD was significantly associated with the decline in attention function (β= -0.29). Thinning of global (β= -0.06), AD signature area (β= -0.06), temporal (β= -0.06), and parietal lobes (β= -0.06) predicted poor verbal fluency over time, while temporal lobe thinning also predicted poor MoCA score (β= -0.19). KD modified the relationship between thinning of global, frontal, and limbic, and change of logical memory function (pinteraction < 0.05). When considering jointly, participants with both KD and cortical thinning had greatest decline in attention function compared with those without KD or cortical thinning (β= -0.51, ptrend = 0.008). Conclusions: KD and cortical thinning have joint effect on cognitive decline, especially the attention function. Reverse associations may exist between cortical thinning and memory function in participants with KD, though the results should be interpreted cautiously as an exploratory analysis. ? 2020 - IOS Press and the authors. All rights reserved.
SDGs
Other Subjects
aged; Article; attention disturbance; brain radiography; brain size; cognitive defect; cohort analysis; controlled study; cortical thickness (brain); executive function; female; follow up; frontal lobe; glomerulus filtration rate; hippocampus; human; hyperlipidemia; hypertension; insula; kidney dysfunction; limbic cortex; logic; longitudinal study; major clinical study; male; memory; mental deterioration; Montreal cognitive assessment; nuclear magnetic resonance imaging; occipital lobe; parietal lobe; priority journal; prospective study; temporal lobe; cognitive defect; dementia assessment; diagnostic imaging; kidney disease; psychology; Aged; Cerebral Cortical Thinning; Cognitive Dysfunction; Cohort Studies; Female; Follow-Up Studies; Humans; Kidney Diseases; Longitudinal Studies; Magnetic Resonance Imaging; Male; Mental Status and Dementia Tests; Prospective Studies
Type
journal article