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Kidney Function and Cognitive Decline in Older Adults: Examining the Role of Neurodegeneration
Guerville F, De Souto Barreto P, Coley N, Andrieu S, Mangin JF, Chupin M, Payoux P, Ousset PJ et al.. Journal of the American Geriatrics Society, 2020-11-20
Topic: Risk, prevention and care in population studies
Background/objectives Cognitive decline associated with impaired kidney function might involve neurodegeneration. Our objectives were to evaluate the longitudinal association between kidney function and cognitive decline in older adults and to assess the involvement of cortical beta-amyloid and hippocampal atrophy (features of Alzheimer's disease (AD)) in this association. Design Secondary analysis of the randomized controlled Multidomain Alzheimer Preventive Trial (MAPT). Settings Thirteen memory centers (France and Monaco, 2008-2016). Participants A total of 1,334 community-dwellers >70 years old without dementia at baseline. Measurements We estimated glomerular filtration rate (eGFR) from serum creatinine using CKD-Epi equation. Cognition was assessed at baseline, 6, 12, 24, 36, 48, and 60 months using a composite Z-score designed for MAPT. The Clinical Dementia Rating (CDR) score was used to assess cognition and functional independence. We examined the association between eGFR and (1) evolution of the composite cognitive Z-score using mixed-effect models and (2) progression on CDR using Cox models and mixed-effect models. Adjustments were made for age, sex, education, ApoE genotype, cardiovascular risk factors and disease, hippocampal volume (measured with magnetic resonance), and cortical beta-amyloid (measured with positron emission tomography). Results Median (IQR) eGFR was 73(60-84) mL/min/1.73 m 2 . Two hundred sixty-nine participants experienced progression on CDR score during follow-up. eGFR Conclusions We did not find a mild to moderate renal insufficiency to be associated with brain imaging features of AD, and our results do not support the involvement of AD mechanisms in the incidence of cognitive impairment and functional decline associated with chronic kidney disease.
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APA 7th
Guerville, F., De Souto Barreto, P., Coley, N., Andrieu, S., Mangin, J. F., Chupin, M., et al. (2021). Kidney Function and Cognitive Decline in Older Adults: Examining the Role of Neurodegeneration. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.16954
Vancouver
Guerville F, De Souto Barreto P, Coley N, Andrieu S, Mangin JF, Chupin M, et al. Kidney Function and Cognitive Decline in Older Adults: Examining the Role of Neurodegeneration. Journal of the American Geriatrics Society. 2021. doi:10.1111/jgs.16954. PMID: 33217785.
BibTeX
@article{guerville2021-33217785,
author = {Guerville, F. and De Souto Barreto, P. and Coley, N. and Andrieu, S. and Mangin, J. F. and Chupin, M. and Payoux, P. and Ousset, P. J. and others},
title = {{Kidney Function and Cognitive Decline in Older Adults: Examining the Role of Neurodegeneration}},
journal = {Journal of the American Geriatrics Society},
year = {2021},
doi = {10.1111/jgs.16954},
pmid = {33217785},
url = {https://doi.org/10.1111/jgs.16954}
}
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Key findings
- Background/objectives Cognitive decline associated with impaired kidney function might involve neurodegeneration.
- Results Median (IQR) eGFR was 73(60-84) mL/min/1.73 m 2 .
- Two hundred sixty-nine participants experienced progression on CDR score during follow-up. eGFR<60 was significantly associated with progression on CDR score (adjusted hazard ratio (aHR) = 1.35, 95% CI 1.01-1.80) and with both the cognitive and functional independence components of CDR, but not with the evolution of the composite cognitive Z-score (adjusted β-coefficient -0.004, 95% CI -0.014; 0.006).
Why it matters
This study did not find mild to moderate renal insufficiency to be associated with brain imaging features of Alzheimer disease, and its results do not support Alzheimer mechanisms in the incidence of cognitive decline related to kidney function. It is about kidney function and cognition, not about treating, curing or preventing Alzheimer disease.
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Study details
- Study designlongitudinal study
- Participants1,334
- Evidence strengthHigh
How this study scored 66/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 63 of the 96 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,334 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 3 / 7 | Cited 29 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.1 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 2 / 6 | Cited 2.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 3 / 3 | Centre National de la Recherche Scientifique: institution h-index 2,511 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 10 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 33217785) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 63 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 63 of the 96 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
What each of these 20 components measures, and what this score is not →
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