Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer's disease in a residential aged care facility: a cross-sectional study

• Published in: BMC geriatrics Vol. 20; no. 1; p. 391
• Main Authors: Wu, Jia-Jyun, Weng, Shuo-Chun, Liang, Chih-Kuang, Lin, Chu-Sheng, Lan, Tsuo-Hung, Lin, Shih-Yi, Lin, Yu-Te
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07-10-2020; BioMed Central; BMC
• Subjects: Activities of Daily Living; Advertising executives; Age; Aged; Aged, 80 and over; Albumin; Alzheimer Disease - blood; Alzheimer Disease - diagnosis; Alzheimer Disease - epidemiology; Alzheimer's disease; Analysis; Anemia; Clinical dementia rating; Cognitive ability; Comorbidity; Cross-Sectional Studies; Dementia; Dementia disorders; Diabetes; Diagnosis; Epidermal growth factor receptors; Female; Gender; Geriatrics; Glomerular filtration rate; Glomerular Filtration Rate - physiology; Glycosylated hemoglobin; Health facilities; Hemoglobin; Hemoglobins - analysis; Hospitals; Humans; Hypertension; Kidney diseases; Kidney Function Tests - methods; Male; Malnutrition; Medical diagnosis; Medical research; Memory; Mini-mental state examination; Neurodegenerative diseases; Older people; Oldest old people; Oldest-old; Patients; Risk factors; Serum Albumin - analysis; Severity of Illness Index; Taiwan - epidemiology; Veterans; Taiwan; Oldest-old; Mini-mental state examination; Clinical dementia rating; Alzheimer’s disease; Glomerular filtration rate
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-020-01789-0

Chronic kidney disease (CKD), low serum albumin, and anemia are known risk factors for cognitive decline in older people. We investigated the association between kidney function and cognitive impairment severity in oldest-old people with a diagnosis of Alzheimer's disease (AD).
A cross-sectional study of patients aged 80 years and older was conducted at a veterans' home in Taiwan between 2012 and 2016. Their estimated glomerular filtration rate (eGFR) was determined using the Modification of Diet in Renal Diseases (MDRD) equation. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR).
A total of 84 patients (age mean ± SD, 86.6 ± 3.9 years) had MMSE scores of 10.1 ± 6.7, and CDR scores of 1.6 ± 0.7. The average eGFR was 61.7 ± 21.5 mL/min/1.73m
. The mean hemoglobin concentration was 12.7 ± 1.7 g/dl, and the mean albumin concentration was 4.5 ± 4.8 g/dl. Multivariate regression analyses showed that scores of CDR were significantly correlated with eGFR after adjustment for potential confounders. The scores of MMSE were significantly correlated with serum albumin and hemoglobin after adjustment for potential confounders.
We found dementia severity was significantly associated with kidney function, serum albumin, and hemoglobin in the oldest-old with AD. We recommend that oldest-old people with a diagnosis of AD be evaluated to determine kidney function, as well as nutritional and hematological status. Further study is needed to establish whether prevention of CKD deterioration, and correction of malnutrition and anemia may help to slow cognitive decline in oldest-old people with dementia.