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Mid-Life Proteinuria and Late-Life Cognitive Function and Dementia in Elderly Men

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Background:

Impaired renal function has been linked to cognitive impairment. We assessed mid-life proteinuria and late-life cognitive function in elderly Asian men.

Methods:

The Honolulu Heart Program is a prospective study that began in 1965 with 8006 Japanese-American men aged 45 to 68 years. Mid-life proteinuria was detected by urine dipstick in 1971 to 1974. The Honolulu-Asia Aging Study began 20 years later, with cognitive assessment by the Cognitive Abilities Screening Instrument (CASI) in 3734 men. Standard criteria were used to classify 8-year incident dementia and subtypes.

Results:

The age-adjusted incidence of dementia increased significantly from 13.8, to 22.8, to 39.7 per 1000 person years follow-up, among those with no, trace, and positive mid-life proteinuria (P=0.004). Using linear regression adjusting for age, education, APOEε4, stroke, hypertension, systolic blood pressure, diabetes, fasting blood glucose, physical activity, and baseline CASI, those with positive proteinuria had significantly higher annual change in CASI over 8 years follow-up (−1.24, P=0.02) (reference=no proteinuria). Multivariate Cox regression found that positive proteinuria had a significant association with incident all-cause dementia (RR=2.66; 95%CI, 1.09-6.53; P=0.03), but no significant associations with incident Alzheimer disease or vascular dementia.

Conclusion:

Mid-life proteinuria was an independent predictor for late-life incident all-cause dementia and cognitive decline over 8 years.
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Keywords: Japanese-American men; cognitive decline; dementia; longitudinal cohort study; proteinuria

Document Type: Research Article

Affiliations: 1: Department of Geriatric Medicine, The John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Department of Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, IL 2: Kuakini Medical Center 3: Department of Geriatric Medicine, The John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu-shi, Shiga-ken, Japan 4: Department of Geriatric Medicine, The John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii 5: National Institute on Aging, Bethesda, MD 6: Department of Geriatric Medicine, The John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Veterans Affairs Pacific Islands Health Care System, Honolulu, HI 7: Department of Geriatric Medicine, The John A. Hartford Foundation Center of Excellence in Geriatrics, John A. Burns School of Medicine, University of Hawaii, Kuakini Medical Center

Publication date: July 1, 2015

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