Original InvestigationPathogenesis and Treatment of Kidney DiseaseKidney Function and Cognitive Impairment in US Adults: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Section snippets
Study Design
The REasons for Geographic and Racial Differences in Stroke (REGARDS) Study is a nationally representative sample of adults aged 45 years and older in the US population. Recruitment of the REGARDS cohort has been described previously.7 Briefly, participants were identified from commercially available lists of residents and recruited through an initial mailing followed by telephone contact. The cooperation rate in REGARDS was 64.6%, and the participation rate was 44.7%. Both are similar to rates
Results
A total of 24,512 participants were recruited into the cohort between January 1, 2004, and November 1, 2007. Of these participants, 23,499 had a nonmissing serum creatinine measurement, and 23,469 of these participants underwent cognitive function testing (Fig 1). We excluded 64 individuals with eGFR less than 10 mL/min/1.73 m2, leaving 23,405 participants in the analytic cohort.
Participants included in our analyses had a mean age of 64.9 ± 9.6 (SD) years, 41.0% were African American, and 40.5%
Discussion
In a large national sample of African American and white adults, individuals with lower levels of kidney function were more likely to have cognitive impairment compared with individuals with normal kidney function, independent of prevalent cardiovascular disease and cardiovascular risk factors. These results suggest that CKD, in addition to other modifiable cardiovascular risk factors, may be an important marker of cognitive impairment in US adults.
These results confirm and extend previous
Acknowledgements
The authors acknowledge the participating investigators and institutions: University of Alabama at Birmingham, Birmingham, AL (Study PI, Data Coordinating Center, Survey Research Unit): George Howard, Leslie McClure, Virginia Howard, Libby Wagner, Virginia Wadley, Rodney Go; University of Vermont (Central Laboratory): Mary Cushman; Wake Forest University (ECG Reading Center): Ron Prineas; Alabama Neurological Institute (Stroke Validation Center, Medical Monitoring): Camilo Gomez, David Rhodes,
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Originally published online as doi:10.1053/j.ajkd.2008.05.004 on June 27, 2008.