Cognitive and kidney function: results from a british birth cohort reaching retirement age.


Silverwood, RJ; Richards, M; Pierce, M; Hardy, R; Sattar, N; Ferro, C; Savage, C; Kuh, D; Nitsch, D; NSHD scientific and data collection teams, ; (2014) Cognitive and kidney function: results from a british birth cohort reaching retirement age. PLoS One, 9 (1). e86743. ISSN 1932-6203 DOI: https://doi.org/10.1371/journal.pone.0086743

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Abstract

BACKGROUND Previous studies have found associations between cognitive function and chronic kidney disease. We aimed to explore possible explanations for this association in the Medical Research Council National Survey of Health and Development, a prospective birth cohort representative of the general British population. METHODS Cognitive function at age 60-64 years was quantified using five measures (verbal memory, letter search speed and accuracy, simple and choice reaction times) and glomerular filtration rate (eGFR) at the same age was estimated using cystatin C. The cross-sectional association between cognitive function and eGFR was adjusted for background confounding factors (socioeconomic position, educational attainment), prior cognition, and potential explanations for any remaining association (smoking, diabetes, hypertension, inflammation, obesity). RESULTS Data on all the analysis variables were available for 1306-1320 study members (depending on cognitive measure). Verbal memory and simple and choice reaction times were strongly associated with eGFR. For example, the lowest quartile of verbal memory corresponded to a 4.1 (95% confidence interval 2.0, 6.2) ml/min/1.73 m(2) lower eGFR relative to the highest quartile. Some of this association was explained by confounding due to socioeconomic factors, but very little of it by prior cognition. Smoking, diabetes, hypertension, inflammation and obesity explained some but not all of the remaining association. CONCLUSIONS These analyses support the notion of a shared pathophysiology of impaired cognitive and kidney function at older age, which precedes clinical disease. The implications of these findings for clinical care and research are important and under-recognised, though further confirmatory studies are required.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Medical Statistics
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 24482683
Web of Science ID: 330283100205
URI: http://researchonline.lshtm.ac.uk/id/eprint/1520145

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