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The mediating role of nutritional indicators in the association between estimated glomerular filtration rate and cognitive impairment in older adults

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机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Geriatr, 1 Dong Jiao Min Xiang, Beijing 100730, Peoples R China
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关键词: cognitive impairment eGFR mediation nutrition older people

摘要:
Background: Cognitive impairment (CI) is common in older adults, especially those with renal dysfunction. We aimed to investigate the complex relationships among renal function, nutritional status, and CI in older people free from late chronic kidney disease (CKD) and severe CI. Methods: A study of older people (>= 60 years old) with an estimated glomerular filtration rate (eGFR) of >30 mL/min/1.73 m(2) and Montreal Cognitive Assessment (MoCA) scores of >10 (n = 237) was conducted at Beijing Tongren Hospital. Their eGFR was determined using the CKD-EPI-cr-Cysc equation. Cognitive function was evaluated with the MoCA. We tested the relationship between eGFR and MoCA scores using Spearman correlation analysis and multivariate logistic regression analysis. We then conducted a mediation analysis to figure out the mediating roles of nutritional indicators (Mini Nutritional Assessment-Short Form (MNA-SF) scores, albumin (ALB), and haemoglobin (HGB)) between the eGFR and MoCA scores. Results: The incidence of CI was 48.5% (115/237) in older people. Spearman correlation analysis revealed that the better the kidney function, the better the cognitive function (R = 0.297, P < 0.001). Multivariate logistic regression analysis revealed that eGFR decrease per 15 mL/min/1.73 m(2) (OR: 1.415, 95% confidence interval: 1.055-1.896, P = 0.020) was related to CI after adjusting for age and sex. However, the eGFR was not associated with cognitive decline after adjusting for nutritional indicators, behavioural risk factors, other biomarkers, and chronic conditions, suggesting that eGFR is not independently associated with CI. Mediation analysis revealed that the MNA-SF scores (a*b = 0.006 (0.0002-0.012)) and HGB (a*b = 0.008 (0.001-0.017)) were mediating factors between the eGFR and MoCA scores. Conclusions: A decline in renal function can directly lead to CI and can also exacerbate cognitive deficits through intermediary factors such as MNA-SF scores and HGB. Therefore, correcting anaemia and improving nutritional status are significantly important for enhancing cognitive function in older patients, especially those with renal dysfunction.

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出版当年[2023]版:
大类 | 4 区 医学
小类 | 4 区 老年医学 4 区 精神病学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 老年医学 4 区 精神病学
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出版当年[2022]版:
Q4 GERIATRICS & GERONTOLOGY Q4 PSYCHIATRY
最新[2023]版:
Q3 PSYCHIATRY Q3 GERIATRICS & GERONTOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

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第一作者机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Geriatr, 1 Dong Jiao Min Xiang, Beijing 100730, Peoples R China
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