Cognitive function and the risk of death in chronic kidney disease

Kalani L. Raphael, Guo Wei, Tom Greene, Bradley C. Baird, Srinivasan Beddhu

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Background and Aims: Cognitive impairment is a risk factor for death in dialysis patients and the general population. We sought to determine if cognitive impairment is associated with death in people with non-dialysis-dependent chronic kidney disease (CKD), and if so, whether this relationship is greater in the CKD population compared to the general population. Methods: National Health and Nutrition Examination Survey-III participants older than 60 years were asked to subtract 3 from 20 five times and to perform immediate and delayed recall of three items. A cognitive score of 0-11 was assigned based on the number of correct responses. Participants were categorized according to cognitive score (11, 9-10, 6-9, and 0-5) and CKD status. Survival analyses were conducted using Cox models. Results: Within the CKD subpopulation, those in the lowest cognitive score group had a twofold increased hazard of death compared to those with maximum score. Within the non-CKD subpopulation, those in the lowest cognitive score group had a 46% increased hazard of death compared to those with maximum score. However, the difference in the hazards of death in the CKD and non-CKD subpopulations with the lowest cognitive score was not significant (p = 0.99). Conclusions: Low cognitive score is associated with an increased risk of death in elderly individuals with and without CKD; however, there was no interaction of CKD and low cognitive score in this analysis.

Original languageEnglish (US)
Pages (from-to)49-57
Number of pages9
JournalAmerican Journal of Nephrology
Volume35
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Keywords

  • Chronic kidney disease
  • Cognitive function
  • Cognitive score
  • Mortality

ASJC Scopus subject areas

  • Nephrology

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