TY - JOUR
T1 - Dementia risk in renal dysfunction
T2 - a systematic review and meta-analysis of prospective studies
AU - Deckers, Kay
AU - Camerino, Ileana
AU - van Boxtel, Martin P. J.
AU - Verhey, Frans R. J.
AU - Irving, Kate
AU - Brayne, Carol
AU - Kivipelto, Miia
AU - Starr, John M.
AU - Yaffe, Kristine
AU - de Leeuw, Peter W.
AU - Köhler, Sebastian
N1 - © 2016 American Academy of Neurology.
PY - 2017/1/10
Y1 - 2017/1/10
N2 - OBJECTIVE: Renal dysfunction has been linked with increased risk for cognitive impairment and dementia, but studies are conflicting. For that reason, the aim of the present systematic review and meta-analysis is to summarize the best available evidence on the prospective association between potential markers of renal dysfunction and development of cognitive impairment or dementia.METHODS: Medline, Embase, and Cochrane Database of Systematic Reviews were searched for potential publications until August 1, 2016. Studies were eligible if they fulfilled the following criteria: population-based study, prospective design, ≥100 participants, aged ≥45 years, ≥1 year follow-up, and cognition/dementia outcomes. Where appropriate, random effects meta-analyses were conducted yielding pooled odds ratios (OR) and 95% confidence intervals (CI).RESULTS: Twenty-two out of 8,494 abstracts fulfilled the eligibility criteria. Sufficient evidence was found for albuminuria, mixed results for estimated glomerular filtration rate (eGFR), insufficient support for cystatin C, and tentative evidence for serum creatinine and creatinine clearance. Meta-analyses of 5 studies representing 27,805 persons showed a 35% increased risk of cognitive impairment or dementia in those with albuminuria (OR 1.35, 95% CI 1.06-1.73, p = 0.015), whereas eGFR <60 mL/min/1.73 m(2) showed no significant association (OR 1.28, 95% CI 0.99-1.65, p = 0.063). No meta-analyses could be done for serum creatinine, creatinine clearance, or cystatin C.CONCLUSIONS: The overall evidence for an association between renal dysfunction and cognitive impairment or dementia is modest. Evidence suggests that albuminuria is associated with higher odds of developing cognitive impairment or dementia.
AB - OBJECTIVE: Renal dysfunction has been linked with increased risk for cognitive impairment and dementia, but studies are conflicting. For that reason, the aim of the present systematic review and meta-analysis is to summarize the best available evidence on the prospective association between potential markers of renal dysfunction and development of cognitive impairment or dementia.METHODS: Medline, Embase, and Cochrane Database of Systematic Reviews were searched for potential publications until August 1, 2016. Studies were eligible if they fulfilled the following criteria: population-based study, prospective design, ≥100 participants, aged ≥45 years, ≥1 year follow-up, and cognition/dementia outcomes. Where appropriate, random effects meta-analyses were conducted yielding pooled odds ratios (OR) and 95% confidence intervals (CI).RESULTS: Twenty-two out of 8,494 abstracts fulfilled the eligibility criteria. Sufficient evidence was found for albuminuria, mixed results for estimated glomerular filtration rate (eGFR), insufficient support for cystatin C, and tentative evidence for serum creatinine and creatinine clearance. Meta-analyses of 5 studies representing 27,805 persons showed a 35% increased risk of cognitive impairment or dementia in those with albuminuria (OR 1.35, 95% CI 1.06-1.73, p = 0.015), whereas eGFR <60 mL/min/1.73 m(2) showed no significant association (OR 1.28, 95% CI 0.99-1.65, p = 0.063). No meta-analyses could be done for serum creatinine, creatinine clearance, or cystatin C.CONCLUSIONS: The overall evidence for an association between renal dysfunction and cognitive impairment or dementia is modest. Evidence suggests that albuminuria is associated with higher odds of developing cognitive impairment or dementia.
KW - CHRONIC KIDNEY-DISEASE
KW - GLOMERULAR-FILTRATION-RATE
KW - SMALL-VESSEL DISEASE
KW - CYSTATIN-C
KW - COGNITIVE FUNCTION
KW - OLDER-ADULTS
KW - CARDIOVASCULAR HEALTH
KW - ALZHEIMERS-DISEASE
KW - VASCULAR-DISEASE
KW - DELPHI CONSENSUS
U2 - 10.1212/WNL.0000000000003482
DO - 10.1212/WNL.0000000000003482
M3 - Article
C2 - 27974647
SN - 0028-3878
VL - 88
SP - 198
EP - 208
JO - Neurology
JF - Neurology
IS - 2
ER -