Renal function affects hippocampal volume and cognition: The role of vascular burden and amyloid deposition

for the Alzheimer's Disease Neuroimaging Initiative

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Aim: We determined if differences in renal function, even within normal levels, influenced hippocampal volume (HCV) and cognition. Methods: Cognitively normal (CN) and mild cognitive impairment (MCI) subjects with eGFR ≥ 60 ml/min/1.73m 2 were selected from the ADNI database (N = 1,269) and divided into three groups (eGFR 60–75, 75–90 and ≥90). Associations between eGFR, HCV and cognition scores were examined using regression methods, and random-coefficient models. The relationship between various factors, such as vascular burden and brain amyloid deposition, were investigated using path analysis. Results: Higher eGFR was associated with larger HCVs and better cognition in all subjects at baseline. In MCI subjects, hippocampal atrophy in the eGFR ≥ 90 group progressed at just half the rate of the eGFR 75–90 group (P =.006), and was also somewhat slower than the eGFR 60–75 group (P =.08). A comprehensive path model linking eGFR, HCV and cognition, and integrating vascular burden and amyloid deposition, is proposed. Conclusions: Higher renal function was associated with slower hippocampal atrophy and cognitive decline even within normal levels of renal function. This relationship was mediated mainly through cardiovascular risk burden and amyloid deposition. Further studies examining neuroinflammation are needed. Geriatr Gerontol Int 2017; 17: 1899–1906.

Original languageEnglish
Pages (from-to)1899-1906
Number of pages8
JournalGeriatrics and Gerontology International
Volume17
Issue number11
DOIs
StatePublished - Nov 2017

Bibliographical note

Funding Information:
Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging and the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: Alzheimer's Association; Alzheimer's Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc.; Biogen Idec Inc.; Bristol-Myers Squibb Company; Eisai Inc.; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd and its affiliated company Genentech, Inc.; Fujirebio; GE Healthcare; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research & Development, LLC.; Johnson & Johnson Pharmaceutical Research & Development LLC.; Medpace, Inc.; Merck & Co., Inc.; Meso Scale Diagnostics, LLC.; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Synarc Inc.; and Takeda Pharmaceutical Company. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Disease Cooperative Study at the University of California, San Diego. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California. This study was also supported by the Korean Alzheimer's Disease Neuroimaging Initiative (K-ADNI), which is funded by a grant of the Korea Healthcare technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI12C0713).

Publisher Copyright:
© 2017 Japan Geriatrics Society

Keywords

  • dementia
  • glomerular filtration rate
  • hippocampus
  • kidney
  • vascular burden

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