Kidney function and risk of dementia: Observational study, meta-analysis, and two-sample mendelian randomization study

Kjærgaard, Alisa D; Ellervik, Christina; Witte, Daniel R.; Nordestgaard, Børge G.; Frikke‐Schmidt, Ruth; Bojesen, Stig E.

doi:10.1007/s10654-022-00923-z

Cited by 11 publications

(7 citation statements)

References 38 publications

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“…Among 90 369 adults in the CGPS, of whom 2468 developed dementia over 15 years of follow-up, age- and sex-standardized percentile of eGFR below the median versus above was associated with 9% higher risk of dementia (95% CI, 1%–18% higher). 99 In a meta-analysis of >460 000 Scandinavian adults conducted by the same authors, there was a dose-response pattern: Risk of dementia was 1.14 times as high (95% CI, 1.06–1.22) for eGFR 60 to 90 mL·min −1 ·1.73 m −2 , 1.31 times as high (95% CI, 0.92–1.87) for eGFR 30 to 59 mL·min −1 ·1.73 m −2 , and 1.91 times as high (95% CI, 1.21–3.01) for eGFR <30 mL·min −1 ·1.73 m −2 relative to eGFR >90 mL·min −1 ·1.73 m −2 . 99…”

Section: Brain Healthmentioning

confidence: 99%

“…99 In a meta-analysis of >460 000 Scandinavian adults conducted by the same authors, there was a dose-response pattern: Risk of dementia was 1.14 times as high (95% CI, 1.06–1.22) for eGFR 60 to 90 mL·min −1 ·1.73 m −2 , 1.31 times as high (95% CI, 0.92–1.87) for eGFR 30 to 59 mL·min −1 ·1.73 m −2 , and 1.91 times as high (95% CI, 1.21–3.01) for eGFR <30 mL·min −1 ·1.73 m −2 relative to eGFR >90 mL·min −1 ·1.73 m −2 . 99…”

Section: Brain Healthmentioning

confidence: 99%

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2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Martin,

Aday,

Almarzooq

et al. 2024

Circulation

458

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BACKGROUND: The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year’s worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Section: Brain Healthmentioning

confidence: 99%

Section: Brain Healthmentioning

confidence: 99%

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Martin,

Aday,

Almarzooq

et al. 2024

Circulation

458

View full text Add to dashboard Cite

show abstract

“…One of these studies reported an association between eGFR decline and risk of vascular dementia only ( 12 ), while another study included younger participants (mean age 49.5 years) with better kidney function (mean eGFR 78.8 ml/min/1.73 m 2 ) ( 15 ). A recently published study combining a cohort study, meta-analysis, and Mendelian randomization analyses found no association of impaired kidney function with the risk of dementia in the cohort study or in Mendelian randomization analyses, while in the meta-analysis there was a trend toward increasing estimates for decreasing eGFR for all-cause dementia, but not for AD ( 11 ). In the present study, we found that moderately to severely impaired kidney function was associated with an increased risk of dementia, AD, and vascular dementia.…”

Section: Discussionmentioning

confidence: 99%

Association of Kidney Function With Dementia and Structural Brain Differences: A Large Population-Based Cohort Study

Wang

Guo

et al. 2023

The Journals of Gerontology: Series A

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Background The association between kidney function and dementia risk and the mechanisms underlying this relationship remain unclear. Methods Within the UK Biobank, 191,970 dementia-free participants aged ≥60 (mean age: 64.1 ± 2.9 years) were followed for 16 years to detect incident dementia. Serum creatinine and cystatin C were measured at baseline to calculate estimated glomerular filtration rate (eGFR, mL/min/1.73 m 2). Kidney function was categorized as normal (eGFR ≥ 90), mildly impaired (60 ≤eGFR < 90), or moderately to severely impaired (eGFR < 60). Dementia was assessed based on self-reported medical history and medical records. During the follow-up, a subsample of 12,637 participants underwent brain MRI scans. Volumes of total brain, gray matter, white matter, hippocampus, and white matter hyperintensities were assessed. Results Over the follow-up, 5,327 (2.8%) participants developed dementia. Compared to normal kidney function, there was an increased risk of dementia with moderate to severely impaired kidney function (hazard ratio [HR]=1.53, 95% confidence interval [CI]: 1.32-1.76) but not mildly impaired kidney function. In Laplace regression, dementia onset among people with moderate to severely impaired kidney function occurred 1.53 (95% CI: 0.98–2.08) years earlier than those with normal kidney function. Moderate to severely impaired kidney function was related to significantly lower gray matter volume (β= -0.11, 95% CI: -0.19– -0.03), but not to other brain MRI measures. Conclusions Impaired kidney function is associated with about 50% increased risk of dementia and anticipates dementia onset by more than 1.5 years. Brain neurodegeneration may underlie the kidney function-dementia association.

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“…Currently, modifiable risk factors are combined into predictive models, with the goal of identifying people at-risk for age-related brain disease [7][8][9] . These models often include hypertension [10][11][12] , hypercholesterolemia [13][14][15] , diabetes 16,17 , kidney disease 18,19 , being overweight 20,21 , and hearing impairment [22][23][24] . Previous studies have shown that people are often not aware of the presence of risk factors: only a small proportion of people was able to accurately recall their HbA1c or cholesterol levels (25% and 19% respectively) 25,26 .…”

Section: Introductionmentioning

confidence: 99%

Reliability of self-reported risk factors for age-related brain disease

Tack,

Senff,

Kimball

et al. 2024

Preprint

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Importance:modifiable risk factors, including hypertension, hypercholesterolemia, diabetes, kidney disease, hearing impairment, and being overweight, increase risk of stroke, dementia, and late life depression (LLD), but may be poorly understood by patients.Objective:To aid in the design of brain health risk stratification tools, we aimed to determine whether self-reported modifiable risk factors can identify at-risk patients on a population level.Design:cohort study using cross-sectional data of ten iterations of the National Health and Examination Surveys (NHANES) from 1999 to 2018. Analyses were conducted between February and April of 2024.Setting:US population-based cohortsParticipants:all participants who had both questionnaire data and objective measurements available.Exposure:we collected data on answers to common questions and compared these to objectively measured risk factors for age-related brain disease.Main outcomes and measures:we compared answers to simple questions to objectively measured risk factors. We reported means and 95% confidence intervals of objective measurements, created confusion matrices to determine common metrics, and compared performance of individual questions. We defined a question reliable if performance, measured through F1 scores, was > 0.7, as moderately reliable if F1 score was 0.5-0.7 and as unreliable if F1 score was < 0.5.Results:Participants with both objective measurements and questionnaire data ranged from 16,966 (median age 32, 9,113 [20%] black, 19,993 [45%] white) in hearing impairment to 63,834 (median age 39, 14,156 [22%] black, 25,754 [40%] white) in diabetes. Mean values of objective measurements were significantly increased across all risk factors in patients that responded ″Yes″ to common questions on their presence compared to those who answered ″No″. Performance of questions in identifying at-risk patients measured by F1 score was 0.25 in kidney disease, 0.44 in hypercholesterolemia, 0.56 in hypertension, 0.59 in hearing impairment, 0.71 in diabetes and 0.81 in being overweight.Conclusion and relevance:in this study of multiple cohorts of up to 63,834 Americans, self-reported awareness of meeting clinical criteria for diabetes or being overweight were reliable, hypertension or hearing impairment were moderately reliable, and hypercholesterolemia or kidney disease were unreliable. These results could be used to guide construction of risk factor screening tools.

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Kidney function and risk of dementia: Observational study, meta-analysis, and two-sample mendelian randomization study

Cited by 11 publications

References 38 publications

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

Association of Kidney Function With Dementia and Structural Brain Differences: A Large Population-Based Cohort Study

Reliability of self-reported risk factors for age-related brain disease

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