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Clinical and Experimental Nephrology

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01-01-2022 | Vascular Dementia | Original article

The association between cognitive impairment/dementia and albuminuria: a systematic review and meta-analysis

Authors: Hongqin Li, Shuailin Zhao, Ruiyu Wang, Baoshan Gao

Published in: Clinical and Experimental Nephrology | Issue 1/2022

Abstract

Background

To identify the association between albuminuria and dementia or cognitive impairment.

Methods

The literature search was performed to identify relevant scientific studies through August 2019, including PubMed/Medline and EMBASE. For inclusion, the studies had to fulfil the following criteria: population-based cohort, case–control or cross-sectional studies; quantifying an association of albuminuria with cognitive impairment or dementia; and reported odds ratio (OR), and the corresponding 95% confidential interval (95% CI). Random effects model was used to yield pooled estimates.

Results

A total of 16 studies (11 cohort studies and five cross-sectional studies) were included in the meta-analyses. Based on the fully adjusted estimates, albuminuria was associated with a significant higher risk of cognitive impairment or dementia. Furthermore, the same trend existed for cognitive impairment and dementia, respectively. In addition, both of Alzheimer’s diseases (AD) and vascular dementia (VaD) were significantly associated with albuminuria.

Conclusion

Albuminuria was significantly associated with cognitive impairment and dementia. Corresponding to an earlier subclinical time-point in kidney disease progress, albuminuria may be a potential factor predicting the future occurrence of dementia.

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Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366(9503):2112–7. https://doi.org/10.1016/S0140-6736(05)67889-0.CrossRefPubMedPubMedCentral

Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63-75.e2. https://doi.org/10.1016/j.jalz.2012.11.007.CrossRefPubMed

Ward A, Arrighi HM, Michels S, Cedarbaum JM. Mild cognitive impairment: disparity of incidence and prevalence estimates. Alzheimers Dement. 2012;8(1):14–21. https://doi.org/10.1016/j.jalz.2011.01.002.CrossRefPubMed

Plassman BL, Williams JW Jr, Burke JR, Holsinger T, Benjamin S. Systematic review: factors associated with risk for and possible prevention of cognitive decline in later life. Ann Intern Med. 2010;153(3):182–93. https://doi.org/10.7326/0003-4819-153-3-201008030-00258.CrossRefPubMed

Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. Lancet Neurol. 2014;13(8):788–94. https://doi.org/10.1016/S1474-4422(14)70136-X.CrossRefPubMed

de la Torre JC. Alzheimer disease as a vascular disorder: nosological evidence. Stroke. 2002;33(4):1152–62. https://doi.org/10.1161/01.str.0000014421.15948.67.CrossRefPubMed

Barzilay JI, Peterson D, Cushman M, Heckbert SR, Cao JJ, Blaum C, et al. The relationship of cardiovascular risk factors to microalbuminuria in older adults with or without diabetes mellitus or hypertension: the cardiovascular health study. Am J Kidney Dis. 2004;44(1):25–34. https://doi.org/10.1053/j.ajkd.2004.03.022.CrossRefPubMed

Deckers K, van Boxtel MP, Schiepers OJ, de Vugt M, Munoz Sanchez JL, Anstey KJ, et al. Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies. Int J Geriatr Psychiatry. 2015;30(3):234–46. https://doi.org/10.1002/gps.4245.CrossRefPubMed

Madero M, Gul A, Sarnak MJ. Cognitive function in chronic kidney disease. Semin Dial. 2008;21(1):29–37. https://doi.org/10.1111/j.1525-139X.2007.00384.x.CrossRefPubMed

10.

Murray AM. Cognitive impairment in the aging dialysis and chronic kidney disease populations: an occult burden. Adv Chronic Kidney Dis. 2008;15(2):123–32. https://doi.org/10.1053/j.ackd.2008.01.010.CrossRefPubMedPubMedCentral

11.

Georgakis MK, Dimitriou NG, Karalexi MA, Mihas C, Nasothimiou EG, Tousoulis D, et al. Albuminuria in association with cognitive function and dementia: a systematic review and meta-analysis. J Am Geriatr Soc. 2017;65(6):1190–8. https://doi.org/10.1111/jgs.14750.CrossRefPubMed

12.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12. https://doi.org/10.1001/jama.283.15.2008.CrossRefPubMed

13.

Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.CrossRefPubMed

14.

Crowe E, Halpin D, Stevens P, Guideline DG. Early identification and management of chronic kidney disease: summary of NICE guidance. BMJ. 2008;337: a1530. https://doi.org/10.1136/bmj.a1530.CrossRefPubMed

15.

Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998;280(19):1690–1. https://doi.org/10.1001/jama.280.19.1690.CrossRefPubMed

16.

Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58. https://doi.org/10.1002/sim.1186.CrossRefPubMed

17.

Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34. https://doi.org/10.1136/bmj.315.7109.629.CrossRefPubMedPubMedCentral

18.

Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50(4):1088–101.CrossRefPubMed

19.

Barzilay JI, Lovato JF, Murray AM, Williamson J, Ismail-Beigi F, Karl D, et al. Albuminuria and cognitive decline in people with diabetes and normal renal function. Clin J Am Soc Nephrol. 2013;8(11):1907–14. https://doi.org/10.2215/cjn.11321112.CrossRefPubMedPubMedCentral

20.

Barzilay JI, Gao P, O’Donnell M, Mann JF, Anderson C, Fagard R, et al. Albuminuria and decline in cognitive function: the ONTARGET/TRANSCEND studies. Arch Intern Med. 2011;171(2):142–50. https://doi.org/10.1001/archinternmed.2010.502.CrossRefPubMed

21.

Barzilay JI, Fitzpatrick AL, Luchsinger J, Yasar S, Bernick C, Jenny NS, et al. Albuminuria and dementia in the elderly: a community study. Am J Kidney Dis. 2008;52(2):216–26. https://doi.org/10.1053/j.ajkd.2007.12.044.CrossRefPubMedPubMedCentral

22.

Takae K, Hata J, Ohara T, Yoshida D, Shibata M, Mukai N, et al. Albuminuria increases the risks for both Alzheimer disease and vascular dementia in community-dwelling Japanese elderly: the Hisayama study. J Am Heart Assoc. 2018. https://doi.org/10.1161/jaha.117.006693CrossRefPubMedPubMedCentral

23.

Weiner DE, Bartolomei K, Scott T, Price LL, Griffith JL, Rosenberg I, et al. Albuminuria, cognitive functioning, and white matter hyperintensities in homebound elders. Am J Kidney Dis. 2009;53(3):438–47. https://doi.org/10.1053/j.ajkd.2008.08.022.CrossRefPubMed

24.

Kurella Tamura M, Muntner P, Wadley V, Cushman M, Zakai NA, Bradbury BD, et al. Albuminuria, kidney function, and the incidence of cognitive impairment among adults in the United States. Am J Kidney Dis. 2011;58(5):756–63. https://doi.org/10.1053/j.ajkd.2011.05.027.CrossRefPubMed

25.

Abbatecola AM, Barbieri M, Rizzo MR, Grella R, Laieta MT, Quaranta E, et al. Arterial stiffness and cognition in elderly persons with impaired glucose tolerance and microalbuminuria. J Gerontol A Biol Sci Med Sci. 2008;63(9):991–6. https://doi.org/10.1093/gerona/63.9.991.CrossRefPubMed

26.

Helmer C, Stengel B, Metzger M, Froissart M, Massy ZA, Tzourio C, et al. Chronic kidney disease, cognitive decline, and incident dementia: the 3C Study. Neurology. 2011;77(23):2043–51. https://doi.org/10.1212/WNL.0b013e31823b4765.CrossRefPubMed

27.

Wei Y, Wei YK, Zhu J. Early markers of kidney dysfunction and cognitive impairment among older adults. J Neurol Sci. 2017;375:209–14. https://doi.org/10.1016/j.jns.2017.01.071.CrossRefPubMed

28.

Wang F, Zhang L, Liu L, Wang H. Level of kidney function correlates with cognitive decline. Am J Nephrol. 2010;32(2):117–21. https://doi.org/10.1159/000315618.CrossRefPubMed

29.

Vupputuri S, Shoham DA, Hogan SL, Kshirsagar AV. Microalbuminuria, peripheral artery disease, and cognitive function. Kidney Int. 2008;73(3):341–6. https://doi.org/10.1038/sj.ki.5002672.CrossRefPubMed

30.

Higuchi M, Chen R, Abbott RD, Bell C, Launer L, Ross GW, et al. Mid-life proteinuria and late-life cognitive function and dementia in elderly men: the Honolulu-Asia Aging Study. Alzheimer Dis Assoc Disord. 2015;29(3):200–5. https://doi.org/10.1097/wad.0000000000000082.CrossRefPubMedPubMedCentral

31.

Gabin JM, Romundstad S, Saltvedt I, Holmen J. Moderately increased albuminuria, chronic kidney disease and incident dementia: the HUNT study. BMC Nephrol. 2019;20(1):261. https://doi.org/10.1186/s12882-019-1425-8.CrossRefPubMedPubMedCentral

32.

O’Hare AM, Walker R, Haneuse S, Crane PK, McCormick WC, Bowen JD, et al. Relationship between longitudinal measures of renal function and onset of dementia in a community cohort of older adults. J Am Geriatr Soc. 2012;60(12):2215–22. https://doi.org/10.1111/j.1532-5415.2012.04238.x.CrossRefPubMedPubMedCentral

33.

Chen XP, Wu J, Peng Q, Huang H, Mao ZX, Huang Y, et al. Relationship between microalbuminuria and cognition in primary hypertension patients. Zhonghua Xin Xue Guan Bing Za Zhi. 2008;36(8):722–5.PubMed

34.

Kurella Tamura M, Xie D, Yaffe K, Cohen DL, Teal V, Kasner SE, et al. Vascular risk factors and cognitive impairment in chronic kidney disease: the Chronic Renal Insufficiency Cohort (CRIC) study. Clin J Am Soc Nephrol. 2011;6(2):248–56. https://doi.org/10.2215/CJN.02660310.CrossRefPubMedPubMedCentral

35.

Deckers K, Camerino I, van Boxtel MP, Verhey FR, Irving K, Brayne C, et al. Dementia risk in renal dysfunction: a systematic review and meta-analysis of prospective studies. Neurology. 2017;88(2):198–208. https://doi.org/10.1212/WNL.0000000000003482.CrossRefPubMedPubMedCentral

36.

Deschamps V, Barberger-Gateau P, Peuchant E, Orgogozo JM. Nutritional factors in cerebral aging and dementia: epidemiological arguments for a role of oxidative stress. Neuroepidemiology. 2001;20(1):7–15. https://doi.org/10.1159/000054752.CrossRefPubMed

37.

Paragh G, Balla P, Katona E, Seres I, Egerhazi A, Degrell I. Serum paraoxonase activity changes in patients with Alzheimer’s disease and vascular dementia. Eur Arch Psychiatry Clin Neurosci. 2002;252(2):63–7. https://doi.org/10.1007/s004060200013.CrossRefPubMed

38.

Hofman A, Ott A, Breteler MM, Bots ML, Slooter AJ, van Harskamp F, et al. Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer’s disease in the Rotterdam Study. Lancet. 1997;349(9046):151–4. https://doi.org/10.1016/S0140-6736(96)09328-2.CrossRefPubMed

39.

Launer LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ. The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. JAMA. 1995;274(23):1846–51.CrossRefPubMed

40.

Launer LJ, Ross GW, Petrovitch H, Masaki K, Foley D, White LR, et al. Midlife blood pressure and dementia: the Honolulu-Asia aging study. Neurobiol Aging. 2000;21(1):49–55. https://doi.org/10.1016/s0197-4580(00)00096-8.CrossRefPubMed

41.

White L, Petrovitch H, Hardman J, Nelson J, Davis DG, Ross GW, et al. Cerebrovascular pathology and dementia in autopsied Honolulu-Asia Aging Study participants. Ann N Y Acad Sci. 2002;977:9–23. https://doi.org/10.1111/j.1749-6632.2002.tb04794.x.CrossRefPubMed

42.

Etgen T, Chonchol M, Forstl H, Sander D. Chronic kidney disease and cognitive impairment: a systematic review and meta-analysis. Am J Nephrol. 2012;35(5):474–82. https://doi.org/10.1159/000338135.CrossRefPubMed

43.

Shen Z, Ruan Q, Yu Z, Sun Z. Chronic kidney disease-related physical frailty and cognitive impairment: a systemic review. Geriatr Gerontol Int. 2017;17(4):529–44. https://doi.org/10.1111/ggi.12758.CrossRefPubMed

44.

Toyoda K, Ninomiya T. Stroke and cerebrovascular diseases in patients with chronic kidney disease. Lancet Neurol. 2014;13(8):823–33. https://doi.org/10.1016/S1474-4422(14)70026-2.CrossRefPubMed

45.

Vogels SC, Emmelot-Vonk MH, Verhaar HJ, Koek HL. The association of chronic kidney disease with brain lesions on MRI or CT: a systematic review. Maturitas. 2012;71(4):331–6. https://doi.org/10.1016/j.maturitas.2012.01.008.CrossRefPubMed

Title: The association between cognitive impairment/dementia and albuminuria: a systematic review and meta-analysis
Authors: Hongqin Li
Shuailin Zhao
Ruiyu Wang
Baoshan Gao
Publication date: 01-01-2022
Publisher: Springer Singapore
Keywords: Vascular Dementia
Alzheimer's Disease
Dementia
Alzheimer's Disease
Albuminuria
Vascular Dementia
Dementia
Published in: Clinical and Experimental Nephrology / Issue 1/2022
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI: https://doi.org/10.1007/s10157-021-02127-3

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Abstract

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