Kidney disease and cognitive function: African American-diabetes heart study MIND

Nicholette D. Palmer, Kaycee M. Sink, Susan Carrie Smith, Jianzhao Xu, Donald W. Bowden, Christina E. Hugenschmidt, Christopher T. Whitlow, Jeff D. Williamson, Joseph A Maldjian, Jasmin Divers, Barry I. Freedman

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Aims: Albuminuria and reduced estimated glomerular filtration rate (eGFR) are linked with poorer cognitive performance in European-ancestry populations with advanced nephropathy; relationships in African Americans (AAs) with type 2 diabetes (T2D) are less clear. Tests of cognitive performance, urine albumin:creatinine ratio (UACR), and CKD-EPI eGFR were performed in unrelated AAs with T2D to determine relationships. Methods: Cross-sectional analysis of 263 unrelated AAs with T2D recruited in the African American- Diabetes Heart Study (AA-DHS) MIND. Global cognitive function (mini-mental state exam [3MSE] and Montreal Cognitive Assessment [MoCA]), memory (Rey Auditory Verbal Learning Test [RAVLT]), executive function (Stroop, verbal fluency for animals, and Digit Symbol Copy [DSC]), UACR, and eGFR were determined. Relationships between cognitive tests and renal parameters were assessed using multivariate models, adjusted for age, gender, body mass index, hemoglobin A1c, level of education, hypertension, and LDL cholesterol. Results: Participants had a mean ± SD age of 60.2 ± 9.7 years, 62.7% were female, T2D duration was 14.3 ± 8.9 years, eGFR 86.0 ± 23.2 ml/min/1.73 m 2 , and UACR 155.8 ± 542.1 (median 8.1) mg/g. In adjusted models, higher UACR was associated with worse 3MSE (p = 0.014), MoCA (p = 0.0089), DSC (p = 0.0004), Stroop performance time (p = 0.003), Stroop errors (p = 0.032), and Stroop interference (p = 0.026). Higher eGFR was associated with better performance on DSC (p = 0.0071). Conclusions: In AAs with T2D, albuminuria and eGFR were associated with cognitive function, even in mild kidney disease. These data stress the need for interventions to prevent cognitive decline well before the late stages of kidney disease.

Original languageEnglish (US)
Pages (from-to)200-207
Number of pages8
JournalAmerican Journal of Nephrology
Volume40
Issue number3
DOIs
StatePublished - Jan 1 2014

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Kidney Diseases
Glomerular Filtration Rate
African Americans
Cognition
Type 2 Diabetes Mellitus
Albumins
Creatinine
Urine
Albuminuria
Verbal Learning
Executive Function
LDL Cholesterol
Hemoglobins
Body Mass Index
Cross-Sectional Studies
Hypertension
Kidney
Education
Population

Keywords

  • African Americans
  • Albuminuria
  • Cognition
  • Glomerular filtration rate
  • Kidney disease
  • Type 2 diabetes

ASJC Scopus subject areas

  • Nephrology

Cite this

Palmer, N. D., Sink, K. M., Smith, S. C., Xu, J., Bowden, D. W., Hugenschmidt, C. E., ... Freedman, B. I. (2014). Kidney disease and cognitive function: African American-diabetes heart study MIND. American Journal of Nephrology, 40(3), 200-207. https://doi.org/10.1159/000367669

Kidney disease and cognitive function : African American-diabetes heart study MIND. / Palmer, Nicholette D.; Sink, Kaycee M.; Smith, Susan Carrie; Xu, Jianzhao; Bowden, Donald W.; Hugenschmidt, Christina E.; Whitlow, Christopher T.; Williamson, Jeff D.; Maldjian, Joseph A; Divers, Jasmin; Freedman, Barry I.

In: American Journal of Nephrology, Vol. 40, No. 3, 01.01.2014, p. 200-207.

Research output: Contribution to journalArticle

Palmer, ND, Sink, KM, Smith, SC, Xu, J, Bowden, DW, Hugenschmidt, CE, Whitlow, CT, Williamson, JD, Maldjian, JA, Divers, J & Freedman, BI 2014, 'Kidney disease and cognitive function: African American-diabetes heart study MIND', American Journal of Nephrology, vol. 40, no. 3, pp. 200-207. https://doi.org/10.1159/000367669
Palmer ND, Sink KM, Smith SC, Xu J, Bowden DW, Hugenschmidt CE et al. Kidney disease and cognitive function: African American-diabetes heart study MIND. American Journal of Nephrology. 2014 Jan 1;40(3):200-207. https://doi.org/10.1159/000367669
Palmer, Nicholette D. ; Sink, Kaycee M. ; Smith, Susan Carrie ; Xu, Jianzhao ; Bowden, Donald W. ; Hugenschmidt, Christina E. ; Whitlow, Christopher T. ; Williamson, Jeff D. ; Maldjian, Joseph A ; Divers, Jasmin ; Freedman, Barry I. / Kidney disease and cognitive function : African American-diabetes heart study MIND. In: American Journal of Nephrology. 2014 ; Vol. 40, No. 3. pp. 200-207.
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AU - Xu, Jianzhao

AU - Bowden, Donald W.

AU - Hugenschmidt, Christina E.

AU - Whitlow, Christopher T.

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KW - Glomerular filtration rate

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