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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Hong, Jingyao Chu, Nadia M. Cockey, Samuel G. Long, Jane Cronin, Nicolai Ghildayal, Nidhi Hall, Rasheeda K. Huisingh-Scheetz, Megan Scherer, Jennifer Segev, Dorry L. McAdams-DeMarco, Mara A. |
| Abstract | Background Though older adults with chronic kidney disease (CKD) have a greater mortality risk than those without CKD, traditional risk factors poorly predict mortality in this population. Therefore, we tested our hypothesis that two common geriatric risk factors, frailty and cognitive impairment, and their co-occurrence, might improve mortality risk prediction in CKD. Methods Among participants aged ≥ 60 years from National Health and Nutrition Examination Survey (2011–2014), we quantified associations between frailty (physical frailty phenotype) and global/domain-specific cognitive function (immediate-recall [CERAD-WL], delayed-recall [CERAD-DL], verbal fluency [AF], executive function/processing speed [DSST], and global [standardized-average of 4 domain-specific tests]) using linear regression, and tested whether associations differed by CKD using a Wald test. We then tested whether frailty, global cognitive impairment (1.5SD below the mean), or their combination improved prediction of mortality (Cox models, c-statistics) compared to base models (likelihood-ratios) among those with and without CKD. Results Among 3,211 participants, 1.4% were cognitively impaired, and 10.0% were frail; frailty and cognitive impairment co-occurrence was greater among those with CKD versus those without (1.2%vs.0.1%). Frailty was associated with worse global cognitive function (Cohen’s d = -0.26SD,95%CI -0.36,-0.17), and worse cognitive function across all domains; these associations did not differ by CKD (pinteractions > 0.05). Mortality risk prediction improved only among those with CKD when accounting for frailty (p[likelihood ratio test] < 0.001) but not cognitive impairment. Conclusions Frailty is associated with worse cognitive function regardless of CKD status. While CKD and frailty improved mortality prediction, cognitive impairment did not. Risk prediction tools should incorporate frailty to improve mortality prediction among those with CKD. |
| Related Links | https://bmcnephrol.biomedcentral.com/counter/pdf/10.1186/s12882-024-03613-y.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712369 |
| DOI | 10.1186/s12882-024-03613-y |
| Journal | BMC Nephrology |
| Issue Number | 1 |
| Volume Number | 25 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2024-05-22 |
| Access Restriction | Open |
| Subject Keyword | Nephrology Internal Medicine Frailty CKD Cognitive impairment Mortality |
| Content Type | Text |
| Resource Type | Article |
| Subject | Nephrology |
| Journal Impact Factor | 2.2/2023 |
| 5-Year Journal Impact Factor | 2.6/2023 |
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