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Ratio of urine albumin to creatinine attenuates the association of dementia with hip fracture risk.
Monday,2015-03-09 16:24 America/Los_Angeles — zdrager
| Title | Ratio of urine albumin to creatinine attenuates the association of dementia with hip fracture risk. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Bůzková, P, Barzilay, JI, Fink, HA, Robbins, JA, Cauley, JA, Fitzpatrick, AL |
| Journal | J Clin Endocrinol Metab |
| Volume | 99 |
| Issue | 11 |
| Pagination | 4116-23 |
| Date Published | 2014 Nov |
| ISSN | 1945-7197 |
| Keywords | Aged, Aged, 80 and over, Albuminuria, Creatinine, Dementia, Female, Hip Fractures, Humans, Incidence, Magnetic Resonance Imaging, Male, Mild Cognitive Impairment, Neuropsychological Tests, Prospective Studies, Risk |
| Abstract | <p><b>CONTEXT: </b>Microvascular disease is a leading cause of cognitive impairment. Approximately 50% of people with a hip fracture have cognitive impairment.</p><p><b>OBJECTIVE: </b>We tested the hypothesis that microvascular diseases of the brain (lacunar infarcts and white matter disease [WMD]), kidney (albuminuria [≥ 30 mg/g creatinine] and albumin creatinine ratio [ACR]), and eye (retinal vascular disorders) attenuate the association of cognitive impairment with hip fracture risk.</p><p><b>SETTING: </b>The Cardiovascular Health Cognition Study.</p><p><b>PATIENTS: </b>Three thousand, one-hundred six participants (mean age, ∼ 79 y; 8.84 y median follow-up) with cognitive testing. Subsets received ACR testing (n=2389), brain magnetic resonance imaging scans (n = 2094), and retinal photography (n = 1098).</p><p><b>MAIN OUTCOME MEASURE: </b>Incident hip fracture.</p><p><b>RESULTS: </b>There were 488 participants (16%) with mild cognitive impairment (MCI) and 564 (18%) with dementia. There were 337 incident hip fractures, of which 19% occurred in participants with MCI and 26% in participants with dementia. Adjusted hazard ratios (HR) and 95% confidence interval for hip fracture in participants with MCI were 2.45 (1.67-3.61) and for dementia 2.35 (1.57-3.52). With doubling of ACR, the HR for fracture was attenuated in participants with dementia compared with participants with normal cognition [interaction HR 0.70 (0.55-0.91)]. No such effect was found in participants with MCI. Albuminuria, lacunar infarcts, WMD, and retinal vascular disease (RVD) did not modify the association of dementia or MCI with hip fracture risk.</p><p><b>CONCLUSIONS: </b>ACR attenuates part of the risk of hip fracture in people with dementia, suggesting that these disorders share a common pathogenesis.</p> |
| DOI | 10.1210/jc.2014-2409 |
| Alternate Journal | J. Clin. Endocrinol. Metab. |
| PubMed ID | 25148233 |
| PubMed Central ID | PMC4223436 |
| Grant List | AG023629 / AG / NIA NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01 HC55222 / HC / NHLBI NIH HHS / United States N01HC15103 / HC / NHLBI NIH HHS / United States N01HC75150 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States R01AG20098 / AG / NIA NIH HHS / United States |