Interactive effects of diabetes and impaired kidney function on cognitive performance in old age: a population-based study

BMC Geriatrics

Research Article

Chengxuan Qiu¹  Zhongrui Yan²  Lei Feng³  Zhaoxue Yin⁴  Aiqin Song⁵  Yajun Liang⁶  Chuanzhu Cai⁷  Hui Jiang⁷ 

[1] Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden;Department of Neurology, Jining No. 1 People’s Hospital, Shandong, China;Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, Singapore;Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China;School of Public Health, Jining Medical University, Shandong, China;School of Public Health, Jining Medical University, Shandong, China;Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden;Xing Long Zhuang Hospital, Yankuang Group, Shandong, China;

关键词: Diabetes;    Kidney function;    Cognitive impairment;    Aging;    Population-based study;   

DOI  :  10.1186/s12877-016-0193-6

 received in 2015-11-10, accepted in 2016-01-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe interactive effect between diabetes and impaired kidney function on cognitive impairment in older adults has not yet been reported. The aim of this study was to investigate the association of diabetes and impaired kidney function with cognitive impairment among Chinese older people living in a rural area.MethodsThis cross-sectional study included 1,358 participants (age ≥60 years; 60.5 % women) in the population-based Confucius Hometown Aging Project in Shandong, China. Data on demographics, lifestyle factors, health history, use of medications, global cognitive function, and kidney function were collected through structured interviews, clinical examinations, and blood tests. We defined diabetes as a fasting plasma glucose level ≥7.0 mmol/l or use of hypoglycemic agents, impaired kidney function as glomerular filtration rate estimated from cystatin C (eGFRcys) <60 ml/min/1.73 m2. Cognitive impairment was defined using the education-based cut-off scores of Mini-Mental State Examination (MMSE). Data were analyzed using multiple general linear and logistic regression models.ResultsCognitive impairment was defined in 197 (14.5 %) persons. The multi-adjusted β coefficient of MMSE score associated with diabetes was −0.06 (95 % confidence interval [CI], −0.16, 0.03); the corresponding figures associated with eGFRcys <60, 60–89.9, and ≥90 ml/min/1.73 m2 were −0.15 (−0.28, −0.02), −0.01 (−0.10, 0.08), and 0 (reference) (Ptrend = 0.046), respectively. Diabetes and impaired kidney function showed an interactive effect on cognitive impairment (Pinteraction = 0.02). Compared with individuals having neither diabetes nor impaired kidney function, those with both conditions had a multi-adjusted odds ratio of 4.23 (95 % CI, 2.10–8.49) for cognitive impairment. The relative excess risk due to interaction was 2.74.ConclusionsThis study suggests that concurrent presence of diabetes and impaired kidney function is associated with a substantial likelihood for cognitive impairment in older adults.

【 授权许可】

CC BY   
© Yin et al. 2016