Albuminuria and dementia in the elderly: a community study

Am J Kidney Dis. 2008 Aug;52(2):216-26. doi: 10.1053/j.ajkd.2007.12.044. Epub 2008 May 12.


Background: Dementia is associated with microvascular disease of the retina. In this study, we examine whether cognitive status (normal cognition, mild cognitive impairment, and dementia) is associated with albuminuria, a microvascular disorder of the kidney.

Study design: Cross-sectional analysis.

Setting & participants: 2,316 participants from the Cardiovascular Health Cognition Study who underwent brain magnetic resonance imaging and testing for albuminuria.

Predictor: Doubling of albuminuria.

Outcome: Dementia defined according to neuropsychological and clinical evaluation.

Measurements: Multinomial logistic modeling was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of dementia and mild cognitive impairment with doubling of albuminuria compared with the odds with normal cognition.

Results: 283 participants (12.2%) had dementia, 344 (14.9%) had mild cognitive impairment, and 1,689 (72.9%) had normal cognition. Compared with participants with normal cognition, doubling of albuminuria was associated with increased odds of dementia (OR, 1.22; 95% CI, 1.15 to 1.29). Adjustment for prevalent cardiovascular disease and cardiovascular risk factors, lipid levels, C-reactive protein level, estimated glomerular filtration rate, and apolipoprotein E-4 genotype attenuated this association, but it remained statistically significant (OR, 1.12; 95% CI, 1.03 to 1.22). Mild cognitive impairment was associated with albuminuria on unadjusted analysis, but not with adjustment for other factors.

Limitations: Results are cross-sectional; causality cannot be imputed.

Conclusions: The odds of dementia increased in the presence of albuminuria. These findings suggest a role of shared susceptibility for microvascular disease in the brain and kidney in older adults.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Albuminuria / complications*
  • Albuminuria / epidemiology
  • Albuminuria / urine
  • Brain / pathology
  • Cognition / physiology
  • Cross-Sectional Studies
  • Dementia / diagnosis
  • Dementia / epidemiology*
  • Dementia / etiology
  • Female
  • Humans
  • Incidence
  • Magnetic Resonance Imaging
  • Male
  • Odds Ratio
  • Population Surveillance / methods*
  • Prognosis
  • Retrospective Studies
  • Risk Factors