AKI may increase risk for dementia, cognitive impairment for older adults
Key takeaways:
- The rate of probable dementia was higher for adults with vs. without AKI.
- The composite of mild cognitive impairment and probable dementia was also higher among patients with AKI.
Mild and reversible AKI was tied to an increased risk for probable dementia and mild cognitive impairment in older adults with high cardiovascular risk, data show.
“There has been increased recognition in recent years that AKI can have a sustained impact on health and long-term consequences, including incident or progressive chronic kidney disease, long-term mortality and myocardial infarction,” Kristen L. Nowak, PhD, MPH, director of the clinical vascular physiology laboratory at the University of Colorado Anschutz Medical Camp division of renal diseases and hypertension in Aurora, Colorado, and colleagues wrote. In addition, “CKD is associated with high risk of mild cognitive impairment and dementia. It is also well accepted that acute cognitive dysfunction and delirium can occur with severe AKI as a result of uremic encephalopathy.”
Researchers conducted a retrospective cohort study of 8,148 U.S. adults at high risk for cardiovascular disease and who were enrolled in the Systolic Blood Pressure Intervention Trial between 2010 and 2013. The goal was to determine whether AKI increased the risk of cognitive decline. Patients’ average age was 68 years, 65% were men and 28% had prevalent CKD. Patients with baseline systolic blood pressure between 130 mmm Hg and 180 mm Hg with a blood pressure goal of less than 120 mm Hg were placed in the intensive treatment group, and those with a goal of 140 mm Hg were counted as the standard treatment group. No patients had prior diabetes or stroke, and researchers incorporated all major antihypertensive medication classes to achieve desired blood pressure goals.
The incidence rates of mild cognitive impairment, probable dementia and its composite were higher among 270 patients who had an AKI event, according to the findings. In a fully adjusted model, the researchers found a link between AKI and probable dementia (HR = 1.72; 95% CI, 1.07-2.75) and the composite outcome of probable dementia and mild cognitive impairment (HR = 1.43; 95% CI, 1.01-2.04).
“These results suggest that cognitive function should be monitored following AKI in this patient population,” the researchers wrote. “Further research is needed to continue to elucidate the mechanisms by which AKI may increase susceptibility to cognitive impairment.”
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