Chronic Kidney Disease and Subclinical Brain Infarction Increase the Risk of Vascular Cognitive Impairment: The Sefuri Study
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- 作者：Hiroshi Yao ; MD ; PhD* ; rinkenyao@abelia.ocn.ne.jp ; Yuko Araki ; PhD&dagger ; ; Yuki Takashima ; MD ; PhD* ; Akira Uchino ; MD ; PhD&Dagger ; ; Takefumi Yuzuriha ; MD ; PhD* ; Manabu Hashimoto ; MD ; PhD*
- 关键词：Small vessel disease ; glomerular filtration rate ; vascular cognitive impairment ; magnetic resonance imaging ; silent stroke ; executive function
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：26
- 期：2
- 页码：420-424
- 全文大小：326 K
- 卷排序：26
文摘
The purpose of this study was to determine the complex associations among chronic kidney disease (CKD), subclinical brain infarction (SBI), and cognitive impairment.MethodsWe used structural equation modeling (SEM) to examine the complex relationships among CKD, SBI, and cognitive function with Mini-Mental State Examination (MMSE; global function) and modified Stroop test (executive function) in a population-based cohort of 560 non-demented elderly subjects.ResultsPath analysis based on SEM revealed that the direct paths from estimated glomerular filtration rate (eGFR) to SBI and from SBI to executive function were significant (β = −.10, P = .027, and β = .16, P < .001, respectively). Furthermore, the direct path from eGFR to executive function was also significant (β = −.12, P = .006), indicating that the effects of CKD on executive function are independent of SBI. The direct paths from age and education to global cognitive function were highly significant (β = −.17 and .22, respectively, P < .001), whereas the direct path from eGFR to MMSE was not significant.ConclusionsOur findings indicate that CKD confers a risk of vascular cognitive impairment or executive dysfunction through mechanisms dependent and independent of SBI. Treating CKD may be a potential strategy to protect against vascular cognitive impairment or executive dysfunction in healthy elderly subjects.