Chronic kidney disease is associated with incident cognitive impairment in the elderly: the INVADE study

Nephrol Dial Transplant. 2009 Oct;24(10):3144-50. doi: 10.1093/ndt/gfp230. Epub 2009 May 21.


Background: Limited data exist regarding the relationship between decreased renal function and cognitive impairment.

Methods: A total of 3679 participants of the Intervention Project on Cerebrovascular Diseases and Dementia in the Community of Ebersberg (INVADE) composed the community-based cohort study. Measures of renal function were estimated using the Cockcroft-Gault equation and divided into normal, mild and moderate-to-severe impaired renal function (creatinine clearance >or=60, 45-59 and <45 mL/min/1.73 m(2), respectively). The main outcome measures were cognitive impairment at baseline and new cognitive impairment after a 2-year follow-up. Cognitive function was measured using the 6-Item Cognitive Impairment Test (6CIT). Multiple logistic regression analysis was used to assess the association between renal function and cognitive impairment.

Results: At baseline, 396 participants (10.8%) had cognitive impairment. After the 2-year follow-up, 194 participants (6.2%) developed new cognitive impairment. The incidence of cognitive impairment across the groups with normal renal function, mild and moderate-to-severe kidney disease at baseline were 5.8, 9.9 and 21.5%, respectively. Multiple logistic regression analysis after adjustment for possible confounders including traditional cardiovascular risk factors showed a significant association for participants with moderate-to-severe kidney disease at baseline to develop new cognitive impairment after the 2-year follow-up [odds ratio: 2.14 (95% confidence interval: 1.18-3.87), P = 0.01].

Conclusions: In summary, moderate-to-severe impaired renal function is associated with incident cognitive impairment after 2 years in a large cohort of elderly subjects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease
  • Cognition Disorders / etiology*
  • Female
  • Humans
  • Kidney Diseases / complications*
  • Male
  • Prospective Studies