Biomarkers of Kidney Health and Dual Trajectories of Cognitive and Physical Function in Older Adults

作者：Aman Shrestha, Chixiang Chen, Stephen L. Seliger, Charles Ginsberg, Lindsay M. Miller, Qu Tian, Eleanor M. Simonsick, Peggy M. Cawthon, Michelle Shardell · 发表于：Kidney360 · 年份：2025 · DOI：10.34067/kid.0000001084 · 被引用次数：1 · 研究领域：Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes、Dementia and Cognitive Impairment Research

KEY POINTS: Urine albumin-to-creatinine ratio was associated with multiple dual trajectory groups, while eGFR was only associated with dual decline. Lower α -klotho was associated with dual cognitive-physical decline versus no decline in either process. In healthy older adults, kidney biomarkers may potentially predict long-term cognitive and physical performance. BACKGROUND: Kidney disease contributes to both cognitive and physical decline; whether kidney health biomarkers relate to declining cognitive and physical performance separately and/or together is unknown. METHODS: Among 1902 participants (26% Black; 53% female) in the Health, Aging, and Body Composition Study with intact baseline gait speed (≥0.8 m/s) and cognition (modified mini-mental state score ≥90), we assessed baseline kidney-related biomarkers (eGFR, urine albumin-to-creatinine ratio, serum 25-hydroxyvitamin D, plasma intact parathyroid hormone, plasma α -klotho, serum intact fibroblast growth factor 23, and vitamin D metabolites) with joint trajectories of cognitive and physical performance. Grouped-based trajectory analysis of modified mini-mental state and 20-m usual gait speed up to 10 years yielded three groups: group 1 ( n =660), superior longitudinal cognitive-physical performance; group 2 ( n =744), high sustained cognition and initially lower, declining gait; and group 3 ( n =498), lower initial cognitive-physical performance, both steeply declining. Three sequential multinomial regression models we...