Dual Burden of Kidney Disease and Cognitive Impairment in the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia-Cohort.

INTRODUCTION

Chronic kidney disease (CKD) and cognitive impairment are being increasingly recognized as major public health challenges in aging populations, yet their interrelationship remains underexplored in India.

METHODS

Data from Longitudinal Aging Study in India- Diagnostic Assessment of Dementia (LASI-DAD) cohort was analyzed. Estimated glomerular filtration rate (eGFR) was estimated using serum creatinine, cystatin C, and combined CKD-Epidemiology Collaboration (CKD-EPI) equations. Cognitive performance was assessed using Hindi Mental State Examination (HMSE) and domain-specific cognitive tests.

RESULTS

The prevalence of eGFR <60 ml/min per 1.73 m2 was 22.66% using CKD-EPI creatinine and cystatin C (eGFRcr-cys) equation representing one of the highest reported estimates among community-dwelling older adults. Reduced eGFR showed null associations with HMSE scores and performance in cognitive domains. Risk of cognitive impairment was similar in those with eGFR ≥ 60 ml/min per 1.73 m2 when compared with eGFR < 60 ml/min per 1.73 m2. However, the creatinine to cystatin C ratio demonstrated a positive association (ρ = 0.18, P value: < 0.001) with cognitive performance.

CONCLUSION

No significant association between eGFR and cognition was found in the LASI-DAD cohort. High prevalence of reduced eGFR and cognitive impairment may be attributed to age, modifiable risk factors, and region-specific differences, highlighting the need for further longitudinal research in low- and middle-income countries (LMICs).