From Geriatric Pharmacy Intern Dana Ross Pharm.D(c)
Palm Beach Atlantic University School of Pharmacy
New evidence recently published in Neurology, a medical journal showed faster cognitive decline in the elderly with kidney dysfunction. Study investigators say this suggests kidney dysfunction is a risk factor for cognition problems. When kidney function was impaired, the investigators found a decline in cognition that was related to the patient’s memories. An early sign of Alzheimer’s disease is damage to episodic memory, which is remembering place and time, memories of association, and/ or knowledge of daily activity.
These findings are important to public cognitive health because they provide a risk factor that can be modified in an area of disease progression once thought to be a result of merely non-modifiable risk. A neuroscientist for the Alzheimer’s Disease Center at Rush, Aron Buchman, believes understanding the connection between cognitive decline and kidney function needs further investigation, but could prove to be useful in prevention of cognitive decline for the elderly.
It is thought the reason for the link in kidney and brain function lies in disease states that have a common effect on the vasculature, the blood vessels, of the body such as diabetes and hypertension.
The 886 patients in the study (average age of 81, dwelling in a community and without dementia) were enrolled in the Memory and Aging Project and looked at yearly for six years to detect cognition change. The investigators took a composite score of cognition on the whole and five cognitive skills. The skills looked at visuospatial skill, which is looking at letters, numbers, shapes, and images to compare them; semantic skill, which is conceptual learning and overall understanding; working skill, the ability to use information; and finally episodic recall.
Aging and medications can have an effect on cognition, so investigators ruled out these causes of cognitive decline. The investigators saw that kidney dysfunction was associated with a faster cognitive decline over the six years in areas of memory like episodic, working and semantic recall. They found no link to visuospatial skill or perception. They saw a rate of cognitive decline similar to a patient who was older by seven years at baseline.
Further research is in order but this evidence has the potential to impact public health in a profound way.