Kidney Function and Cognitive Impairment in People Aged 80 Years and Over with Untreated Hypertension: A Cross-Sectional Survey

Abstract

Background/Aims: Both kidney dysfunction and cognitive impairment are common problems in hypertensive patients. However, few studies have explored the association between these conditions in hypertensive patients aged 80 or over. The current study was undertaken to determine the impact of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) on cognitive impairment among an 80-year-old population with untreated hypertension in China. Methods: A total of 395 hypertensive patients aged 80 or over were assessed for the presence of cognitive impairment according to the 30-item Mini-Mental State Examination (MMSE). Cognitive impairment was defined as a score below 24 on MMSE. eGFR was evaluated using the Chinese Modification of Diet in Renal Disease equation. CKD was defined according to categorical approach, which is based on “YES” (eGFR below 60 ml/min) or “NO” (eGFR above 60 ml/min). Results: The mean (SD) age was 83.0 ± 2.6 years for the sample, of whom 69.8% were female. There were 59 (14.9%) and 280 (71.1%) prevalent cases of CKD and cognitive impairment, respectively. CKD patients were older, had higher scores on Activity of Daily Living (ADL), and lower score on MMSE. After controlling for potential confounding, multiple logistic regressions demonstrated that both CKD and eGFR were associated with cognitive impairment in hypertensive patients aged 80 or over. Conclusion: Our study found that both CKD and eGFR were associated with cognitive impairment among hypertensive patients aged 80 or over in China. Therefore, targeted screening for cognitive impairment should be considered in these patients with CKD.

Estimated Glomerular Filtration Rate is not Associated with Alzheimer’s Disease in a Northern Ireland Cohort

“…Our findings support previous reports that showed no association between eGFR and cognitive impairment [6,[20][21][22], but contrast to those that did report a significant association [5,9,[23][24][25][26][27][28][29][30]. In addition, other studies also reported significant associations between renal impairment characterised by the presence of microalbuminuria and cognitive impairment [10,20,21,31].…”

Cognitive Impairment and Structural Neuroimaging Abnormalities Among Patients with Chronic Kidney Disease

“…Further, the association of global CI with WMH and cerebral atrophy was independent of CVD history and CVD risk factors for the whole CKD group. These findings might be supported by previous studies indicating that CKD, per se, contributes to cognitive decline [36], independent of ischemic cerebral lesions [35], and that HD is associated with CI, independent of CVD risk factors, SVI, and brain atrophy [37]. Indeed, white matter lesions, which were shown to be a strong predictor of general CI in our study, could be present not only in stroke but also in multiple sclerosis [38], pyridoxine deficiency, and cerebral metabolic disturbances in CKD patients [18].…”

Idosos mais idosos: uma revisão da literatura

“…Nove artigos abordavam problemas cardíacos (David, Mello, Bruscato, & Moriguchi, 2016;Gomes, et al, 2016;Ho, 2014;Luo, et al, 2014;Pérez-Orcero, et al, 2016;Ragot, Sosner, Dievart, & Herpin, 2014;Rossi, et al, 2016;Wang, et al, 2016;Warwick, et al, 2015), incluindo dados hemodinâmicos e antropométricos como procedimentos a serem utilizados no controle de algumas patologias como hipertensão e outras. Reitera-se a ênfase dos pesquisadores sobre investigações relacionadas aos agravos mais frequentes na saúde do idoso longevo e respectivas terapêuticas.…”

“…Quanto ao método de coleta de dados utilizado nos estudos pesquisados, verificamos uma grande diversidade de instrumentos (31 tipos diferentes). Os instrumentos mais encontrados nesta revisão relacionaram-se à avaliação funcional, em nove artigos (Bonicoli, et al, 2016;Downer, Chen, Wong, & Markides, 2016;Hegendörfer, et al, 2017b;Levinson, et al, 2016;Pego, Nunes, Ferreira, Sousa, & Amaral-Silva,, 2016;Wang, et al, 2016;Warwick, et al, 2015;Yoshida, et al, 2017;Yu, et al, 2017) e instrumentos preditores de risco, em sete artigos (Hegendörfer, et al, 2017b;Levinson, et al, 2016;Luo, et al, 2014;Mione, et al, 2016;Pego, Nunes, Ferreira, Sousa, & Amaral-Silva, 2016;Rinaldi, et al, 2017;Yoshida, et al, 2017). Para Paixão (2005), a definição da avaliação do estado funcional seria "o nível com o qual a pessoa desempenha funções e atividades da vida diária".…”

“…O objetivo de identificar, mais precisamente, os idosos em risco permite estabelecer uma estratificação dessa população. Assim, a chance estimada de adoecimento ou óbito possibilita decisões que organizem as intervenções assistenciais e preventivas, ou ainda que admitam adequada alocação de recursos humanos ou financeiros (Estrella, Oliveira, Sant'Anna, & Caldas, 2009 (Bonicoli, et al, 2016;Wang, et al, 2016;Yu, et al, 2017).…”