Reationship Between Cognitive Impairment And Renal Function Measures In The Elderly

ObjectiveOur objective is to explore the correlation between renal function index and cognitive dysfunction in the elderly,and to provide ideas for the pathogenesis and treatment of cognitive dysfunction.MethodsFrom January 2017 to June 2018,a total of 350 elderly patients with aged ? 60 years old were included in the outpatient and inpatient care department of the affiliated hospital of Qingdao university.Cognitive function of the patients was assessed by the Montreal cognitive assessment scale(MoCA scale),including 242 patients with cognitive impairment and 108 patients with normal cognitive function as the control group.Determination of serum creatinine(Scr),cystatin C(Cys C),uric acid(UA),urea nitrogen(BUN),and other laboratory examination,comparison between the two groups of age,gender,level of education,history of smoking,drinking,hypertension,diabetes,coronary heart disease(CHD),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)whether have statistical significance.Correlation analysis was conducted between the concentration of each indicator of renal function and MoCA scale scores.Logistic regression analyses were performed to assess the association between kidney function measures(Scr,Cys C,UA,BUN,eGFR)and cognitive impairment.A linear regression model was also constructed to examine changes in cognitive functioning scores(MoCA scale score)association with concentration of kidney function measures.Results1.The age,gender,smoking history,history of coronary heart disease,triglyceride(TG)and HDL-C between the two groups were statistically significant(P < 0.05).Education,BMI,drinking history,hypertension,diabetes,total cholesterol(TC),and LDL-C were not statistically significant(P > 0.05).2.Concentrations of cystatin C(Cys C)and creatinine(Scr)in MCI group were higher than those in control group,and the difference was statistically significant(P=0.000).There was no statistically significant difference in concentrations of uric acid(UA)and urea nitrogen(BUN)between the two groups(P > 0.05).3.There was a negative correlation between CysC and Scr concentrations and MoCA scale scores,with correlation coefficients of-0.539 and-0.262,respectively,indicating statistically significant differences(P=0.000).There was no significant correlation between BUN and UA concentration and MoCA score(P > 0.05).4.The results of binary Logistic regression analysis showed that after adjusting for age,gender,education level,smoking history,drinking history,hypertension,diabetes,and coronary heart disease,only Cys C was still closely related to cognitive dysfunction,OR=8.337,95%CI: 1.244 ~ 55.887(P =0.029).5.Linear regression results showed that,similar to Logistic regression analysis results,after adjusting for relevant factors,only serum CysC concentration was significantly correlated with MoCA scale score,? =-1.464,and the difference was statistically significant(P=0.000).Conclusions1.Among all indicators of renal function,Cys C,as a marker of early renal function decline,is most closely related to cognitive function and may be a potentital marker of cognitive dysfunction..2.For the elderly with elevated serum cystatin C,timely cognitive assessment,early screening for mild cognitive impairment and early intervention should be carried out to delay the development of cognitive impairment.