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Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study

BACKGROUND: The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-b...

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Autores principales: Fujiyoshi, Akira, Miura, Katsuyuki, Ohkubo, Takayoshi, Miyagawa, Naoko, Saito, Yoshino, Miyazawa, Itsuko, Shiino, Akihiko, Kadota, Aya, Kadowaki, Sayaka, Hisamatsu, Takashi, Torii, Sayuki, Takashima, Naoyuki, Tooyama, Ikuo, Ueshima, Hirotsugu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japan Epidemiological Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217691/
https://www.ncbi.nlm.nih.gov/pubmed/31130560
http://dx.doi.org/10.2188/jea.JE20180258
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author Fujiyoshi, Akira
Miura, Katsuyuki
Ohkubo, Takayoshi
Miyagawa, Naoko
Saito, Yoshino
Miyazawa, Itsuko
Shiino, Akihiko
Kadota, Aya
Kadowaki, Sayaka
Hisamatsu, Takashi
Torii, Sayuki
Takashima, Naoyuki
Tooyama, Ikuo
Ueshima, Hirotsugu
author_facet Fujiyoshi, Akira
Miura, Katsuyuki
Ohkubo, Takayoshi
Miyagawa, Naoko
Saito, Yoshino
Miyazawa, Itsuko
Shiino, Akihiko
Kadota, Aya
Kadowaki, Sayaka
Hisamatsu, Takashi
Torii, Sayuki
Takashima, Naoyuki
Tooyama, Ikuo
Ueshima, Hirotsugu
author_sort Fujiyoshi, Akira
collection PubMed
description BACKGROUND: The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. METHODS: Our cohort initially comprised 1,094 men aged 40–79 years from a random sample from Shiga, Japan in 2006–2008. Of 853 men who returned for the follow-up examination (2009–2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up (higher CASI scores [range 0 to 100] indicate better cognition). Proteinuria was assessed via dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59–40, and <40 mL/min/1.73 m(2)) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score, with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders. RESULTS: Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (P(trend) = 0.029), and 90.0, 88.5, and 88.5 for eGFR (P(trend) = 0.015) in mutual-adjustment model. CONCLUSIONS: Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline.
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spelling pubmed-72176912020-06-10 Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study Fujiyoshi, Akira Miura, Katsuyuki Ohkubo, Takayoshi Miyagawa, Naoko Saito, Yoshino Miyazawa, Itsuko Shiino, Akihiko Kadota, Aya Kadowaki, Sayaka Hisamatsu, Takashi Torii, Sayuki Takashima, Naoyuki Tooyama, Ikuo Ueshima, Hirotsugu J Epidemiol Original Article BACKGROUND: The association of proteinuria and reduced estimated glomerular filtration rate (eGFR) with cognition needs more clarification. We cross-sectionally examined whether proteinuria and reduced eGFR, even in moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. METHODS: Our cohort initially comprised 1,094 men aged 40–79 years from a random sample from Shiga, Japan in 2006–2008. Of 853 men who returned for the follow-up examination (2009–2014), we analyzed 561 who were ≥65 years, free of stroke, and completed the Cognitive Abilities Screening Instrument (CASI) at follow-up (higher CASI scores [range 0 to 100] indicate better cognition). Proteinuria was assessed via dipstick. eGFR was calculated according to the Chronic Kidney Disease Epidemiology Collaboration Equation. Participants were divided into three groups either by eGFR (≥60, 59–40, and <40 mL/min/1.73 m(2)) or by proteinuria (no, trace, and positive), considered normal, moderate, and advanced, respectively. Using linear regression, we computed mean CASI score, with simultaneous adjustment for proteinuria and eGFR in addition to other potential confounders. RESULTS: Significant trends of lower cognition were observed across the groups of worse proteinuria and lower eGFR independently: multivariable-adjusted mean CASI scores were 90.1, 89.3, and 88.4 for proteinuria (P(trend) = 0.029), and 90.0, 88.5, and 88.5 for eGFR (P(trend) = 0.015) in mutual-adjustment model. CONCLUSIONS: Proteinuria and reduced eGFR, even in their moderate stages, were independently associated with lower cognition in a community-based sample of elderly men. The results suggest the importance of proteinuria and low eGFR for early detection and prevention of cognitive decline. Japan Epidemiological Association 2020-06-05 /pmc/articles/PMC7217691/ /pubmed/31130560 http://dx.doi.org/10.2188/jea.JE20180258 Text en © 2019 Akira Fujiyoshi et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Article
Fujiyoshi, Akira
Miura, Katsuyuki
Ohkubo, Takayoshi
Miyagawa, Naoko
Saito, Yoshino
Miyazawa, Itsuko
Shiino, Akihiko
Kadota, Aya
Kadowaki, Sayaka
Hisamatsu, Takashi
Torii, Sayuki
Takashima, Naoyuki
Tooyama, Ikuo
Ueshima, Hirotsugu
Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study
title Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study
title_full Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study
title_fullStr Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study
title_full_unstemmed Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study
title_short Proteinuria and Reduced Estimated Glomerular Filtration Rate are Independently Associated With Lower Cognitive Abilities in Apparently Healthy Community-Dwelling Elderly Men in Japan: A Cross-sectional Study
title_sort proteinuria and reduced estimated glomerular filtration rate are independently associated with lower cognitive abilities in apparently healthy community-dwelling elderly men in japan: a cross-sectional study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217691/
https://www.ncbi.nlm.nih.gov/pubmed/31130560
http://dx.doi.org/10.2188/jea.JE20180258
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