Indicator Details: Cognitive Function Among Adults with CKD by Kidney Functiona
Data Sources
 
Stratification and Year Choices:

  Source
  • CRIC

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Published literature or one-time analysis, ongoing surveillance not available Published literature or one-time analysis, ongoing surveillance not available

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Footnotes:
a M-MMSE, Modified Mini-Mental State Examination (general cognitive battery, range 0-100); Trails A and B, Trail-Making Test Parts A (visuospatial scanning, motor speed, and executive function) and B (attention; range 0-300 for A and B); Category Fluency (verbal production, semantic memory, and language, range 0-45); Selective Reminding, Buschke Selective Reminding Test (immediate and delayed verbal memory, range 0-12 for each); and Boston Naming (naming of objects presented in pictures, range 0-15). Higher scores represent better function except for Trails A and B. Adapted from Yaffe et al. (2010).




Lower levels of kidney function were associated with lower levels of cognitive functioning in CKD patients, particularly for tasks involving overall cognitive function, visuospatial scanning, motor speed, executive function, attention, and object naming.
Chart Explanation: Overall, cognitive function was worse with more severely reduced kidney function across all measures. The association of decreased cognitive function with reduced kidney function was statistically significant for overall cognitive function (M-MMSE); visuospatial scanning, motor speed, executive function, and attention (Trails A and B); and naming of visual objects (Boston Naming).
The Chronic Renal Insufficiency Cohort (CRIC) study is a cohort study of 3,612 individuals 21-74 years of age with CKD of varying severity, recruited from 13 sites across the United States in 2003-2007. CRIC was designed to study consequences of CKD with a particular focus on cardiovascular illness like myocardial infarction (heart attack) and stroke. As with all cohort studies, participants may not be representative of all those who live in the communities from which they are recruited.

Analyses for this measure were performed in 825 older (55+ years old) adults with CKD enrolled in the CRIC study. Cognitive tests including the Modified Mini-Mental State Examination (general cognitive battery), the Trail-Making Test Parts A and B (visuospatial scanning, motor speed, executive function, and attention), Category (verbal) Fluency (verbal production, semantic memory, and language), Buschke Selective Reminding Test (immediate and delayed verbal memory), and Boston Naming (naming of objects presented in pictures). Complete methods can be found in Yaffe et al. (2010).
FieldData
Description of MeasureCognitive function among adults with CKD
Data SourceCRIC prospective observational cohort study (ancillary)
Type of Data SourcePrivate
Data SetCRIC summarized data
Health Care System DataNo
Regional or National?National
Demographic GroupOlder adults (55-74 years old) with mild to severe CKD who are treated throughout 13 sites in 7 U.S. centers and enrolled in the CRIC main study
Numerator— (mean score)
DenominatorOlder adults with cognitive testing results from next scheduled visit
Definition of CKDEstimated GFR of 20-60 (ages 45-64) and 20-50 (ages 65+) ml/min/1.73 m² (for entry into study)
Glomerular filtration rateEstimated, MDRD Study equation
Primary Data Source IndicatorCognitive test scores
Primary Indicator Method of MeasurementInvestigator-administered cognitive testing as part of CRIC study visit
Secondary (1) VariableKidney function
Secondary (1) Indicator Method of MeasurementEstimated eGFR
Frequency of Measurement (Primary)Once (baseline or next visit)
U.S. Region Covered by Primary VariableSeven urban centers throughout the United States (Baltimore, MD; Philadelphia, PA; Cleveland, OH; Detroit, MI; Chicago, IL; New Orleans, LA; Oakland, CA)
Period Currently Available2003–2007
Pending DataNone for baseline/first visit; further visits scheduled
Additional Data Items of InterestStratification variables of interest (age, gender, race/ethnicity), diabetes, labs
Limitations of IndicatorCross-sectional analyses and possibly “healthy cohort” effect
Analytical ConsiderationsData summarized by CRIC investigators (see Yaffe et al.); as with all cohort studies, selection bias and possible confounding
References and Sources:
  • Yaffe K, Ackerson L, Kurella Tamura M, et al. Chronic Renal Insufficiency Cohort Investigators. Chronic kidney disease and cognitive function in older adults: findings from the chronic renal insufficiency cohort cognitive study. J Am Geriatr Soc. 2010;58(2):338-45.
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd