AI Article Synopsis
- Older adults with chronic kidney disease (CKD) have a higher risk of dying, and traditional factors don’t accurately predict this risk, which led researchers to explore frailty and cognitive impairment as predictors.
- The study analyzed data from individuals aged 60 and above to understand how frailty and cognitive function relate to CKD and whether these factors could enhance mortality risk predictions.
- Results showed that frailty significantly worsened cognitive function, and while it improved mortality predictions for those with CKD, cognitive impairment did not add any predictive value.
Article 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 (p > 0.05). Mortality risk prediction improved only among those with CKD when accounting for frailty (p < 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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112880 | PMC |
| http://dx.doi.org/10.1186/s12882-024-03613-y | DOI Listing |
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