Mid-Life Proteinuria and Late-Life Cognitive Function and Dementia in Elderly Men

Abstract

Background Impaired renal function has been linked to cognitive impairment. We assessed mid-life proteinuria and late-life cognitive function in elderly Asian males. Methods The Honolulu Heart Program is a prospective study that began in 1965 with 8,006 Japanese-American men ages 45–68 years. Mid-life proteinuria was detected by urine dipstick in 1971–74. The Honolulu-Asia Aging Study began 20 years later, with cognitive assessment by the Cognitive Abilities Screening Instrument (CASI) in 3,734 men. Standard criteria were used to classify 8-year incident dementia and subtypes. RESULTS The age-adjusted incidence of dementia increased significantly from 13.8, to 22.8, to 39.7 per 1,000 person years follow-up, among those with no, trace and positive mid-life proteinuria, p=0.004. Using linear regression adjusting for age, education, APOEε4, stroke, hypertension, systolic blood pressure, diabetes, fasting blood glucose, physical activity and baseline CASI, those with positive proteinuria had significantly higher annual change in CASI over 8 years follow-up (−1.24, p=0.02), reference=no proteinuria. Multivariate Cox regression found positive proteinuria had a significant association with incident all-cause dementia (RR=2.66, 95%CI=1.09–6.53, p=0.03), but no significant associations with incident Alzheimer’s disease or vascular dementia. CONCLUSION Mid-life proteinuria was an independent predictor for late-life incident all-cause dementia and cognitive decline over 8 years.

Albuminuria in Association with Cognitive Function and Dementia: A Systematic Review and Meta‐Analysis

“…Out of 2,359 results, initially yielded, 32 articles were deemed eligible for meta‐analysis (Figure ).…”

Dementia risk in renal dysfunction

“…33,35,42,45,47 Based on the fully adjusted estimates, albuminuria was associated with a 35% increased risk of cognitive impairment or dementia (p 5 0.015; figure 3). There was mild to moderate heterogeneity (I 2 5 38.2).…”

Chronic renal dysfunction, proteinuria, and risk of Parkinson's disease in the elderly

“…In addition, urinary protein is a strong marker for impaired kidney function and renal damage . Although CKD and proteinuria are well known to be related to cardiovascular risk, they have been indicated to also be associated with noncardiovascular complications, cognitive dysfunction, and poor physical functioning in older adults . In addition, 2 recent cohort studies in Taiwan reported an association between chronic uremia and parkinsonism .…”

“…12 Although CKD and proteinuria are well known to be related to cardiovascular risk, they have been indicated to also be associated with noncardiovascular complications, cognitive dysfunction, and poor physical functioning in older adults. [13][14][15] In addition, 2 recent cohort studies in Taiwan reported an association between chronic uremia and parkinsonism. 16,17 One study showed that uremic patients had an increased risk of the occurrence of parkinsonism compared with nonuremic patients.…”