Impaired kidney function is associated with lower cognitive function in the elder general population. Results from the Good Aging in Skåne (GÅS) cohort study

Månsson, Tomas; Overton, Marieclaire; Pihlsgård, Mats; Elmståhl, Sölve

doi:10.1186/s12877-019-1381-y

Table 3 Results of the cognitive tests in relation to two and four groups based on eGFR

From: Impaired kidney function is associated with lower cognitive function in the elder general population. Results from the Good Aging in Skåne (GÅS) cohort study

(A) Kidney function by two groups
Cognitive test	Cognitive domain	Number of participants	Mean test results	B-coefficient	95% CI for B	p-value
MMSE	Global	2402	26.86	− 0.411	− 0.682, 0.140	0.003
Digit span forward	Learning and memory	2379	6.28	−0.037	− 0.232, 0.158	0.708
Free recall	Learning and memory	2329	6.64	−0.239	−0.482, 0.005	0.054
Recognition	Learning and memory	2299	11.56	−0.562	−0.900, − 0.224	0.001
Word fluency	Language	2376	11.94	−0.663	−1.148, − 0.179	0.007
Digit cancellation	Complex attention	2319	16.77	−0.45	−0.869, − 0.031	0.035
Pattern comparison	Complex attention	2290	26.14	−0.988	−1.697, − 0.279	0.006
TMT B-A	Executive function	1836	18.08	3.707	1.539, 5.874	0.001
Digit span backwards	Executive function	2373	5.33	−0.159	−0.365, 0.047	0.131
Mental rotations	Perceptual-motor	2262	0.6	−0.001	−0.021, 0.019	0.91
Confidence judgement	Meta-memory	2343	0.11	0.003	−0.006, 0.012	0.546
(B) Kidney function by four groups
Cognitive test	Cognitive domain	Number of participants	eGFR level compared to eGFR ≥60 mL/min/1.73 m² as a reference	B-coefficient	95% CI for B	p-value
MMSE	Global	2402	< 30 30- < 45 45- < 60	−0.788 −0.776 −0.246	−1.412, − 0.164 −1.173, − 0.379 − 0.538, 0.046	0.013 < 0.001 0.099
Digit span forward	Learning and memory	2379	< 30 30- < 45 45- < 60	− 0.119 − 0.112 − 0.003	− 0.569, 0.331 − 0.400, 0.175 − 0.214, 0.207	0.603 0.444 0.976
Free recall	Learning and memory	2329	< 30 30- < 45 45- < 60	−0.341 − 0.436 − 0.162	−0.925, 0.243 − 0.798, − 0.075 − 0.425, 0.101	0.252 0.018 0.226
Recognition	Learning and memory	2299	< 30 30- < 45 45- < 60	− 0.985 − 0.809 − 0.433	− 1.790, − 0.179 − 1.312, − 0.306 − 0.799, − 0.066	0.017 0.002 0.021
Word fluency	Language	2376	< 30 30- < 45 45- < 60	−0.533 − 0.832 − 0.620	−1.675, 0.610 − 1.542, − 0.121 − 1.143, − 0.097	0.361 0.022 0.020
Digit cancellation	Complex attention	2319	< 30 30- < 45 45- < 60	−0.307 − 0.744 − 0.371	− 1.321, 0.706 − 1.375, − 0.112 − 0.823, 0.081	0.553 0.021 0.108
Pattern comparison	Complex attention	2290	< 30 30- < 45 45- < 60	−0.577 −2.121 − 0.672	−2.303, 1.148 −3.194, − 1.048 − 1.435, 0.091	0.512 < 0.001 0.084
TMT B-A	Executive function	1836	< 30 30- < 45 45- < 60	2.479 4.993 3.423	−3.202, 8.161 1.612, 8.373 1.081, 5.765	0.392 0.004 0.004
Digit span backwards	Executive function	2373	< 30 30- < 45 45- < 60	−0.303 − 0.309 − 0.094	−0.777, 0.172 − 0.614, − 0.004 − 0.317, 0.128	0.211 0.047 0.404
Mental rotations	Perceptual-motor	2262	< 30 30- < 45 45- < 60	0.016 − 0.003 − 0.002	−0.033, 0.065 − 0.033, 0.027 − 0.024, 0.019	0.530 0.840 0.845
Confidence judgement	Meta-memory	2343	< 30 30- < 45 45- < 60	0.003 0.004 0.002	−0.019, 0.024 − 0.010, 0.017 − 0.007, 0.012	0.796 0.572 0.628

Multiple linear regression models of cognitive tests in relation to kidney function, (A) divided into two groups, impaired kidney function (eGFR < 60 mL/min/1.73 m²) and normal kidney function (eGFR ≥60 mL/min/1.73 m²), with eGFR ≥60 mL/min/1.73 m2 as reference, (B) divided into four groups, severely impaired (eGFR < 30 mL/min/1.73 m²), moderately impaired (eGFR 30- < 45 mL/min/1.73 m²), mildly impaired (eGFR 45- < 60 mL/min/1.73 m²), and normal kidney function (eGFR ≥60 mL/min/1.73 m²), with eGFR ≥60 mL/min/1.73 m² as reference
All analyses were adjusted for age, sex, education and country of origin
Abbreviations: eGFR estimated glomerular filtration rate, CI Confidence interval

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