Cognitive Impairment
Bibliographic record
Abstract
Key Points Early cognitive impairment and dementia raise the risk of developing CKD. Early cognitive impairment and dementia are linked to faster kidney function decline. Background Emerging evidence suggests that better cognition is associated with a lower risk of CKD. However, whether early-onset cognitive impairment (CI) at baseline is linked to rapid eGFR decline or incident CKD remains unclear. Methods We conducted a prospective cohort study of 5761 World Trade Center responders (mean age, 53.8±7.9 years) without CKD at baseline, followed for a mean of 4.2±1.9 years. CI was defined as a Montreal Cognitive Assessment (MoCA) score ≤23, with a subgroup analysis for baseline dementia (MoCA ≤18). Primary outcomes included annual eGFR change and rapid eGFR decline (<−5 ml/min per 1.73 m 2 per year). The secondary outcome was incident CKD (eGFR <60 ml/min per 1.73 m 2 or diagnosis code). Multivariable Cox proportional hazards models and linear regressions were used for binary and continuous outcomes, respectively. Sensitivity analyses included looking at the effect of baseline mild CI (MoCA score 19–23), propensity matching for demographics, baseline age younger than 60 years, removal of baseline post-traumatic stress disorder/depression or baseline head trauma/stroke/cardiovascular disease, and after exclusion of those who died during follow-up. Results At baseline, 1446 (25%) individuals had CI, while 89 (2%) had dementia. The mean baseline eGFR was 91.1 ml/min per 1.73 m 2 , with an overall decline of −1.2 ml/min per 1.73 m 2 per year. Rapid eGFR decline occurred in 550 (10%) individuals. After adjusting for age, sex, race and ethnicity, comorbidities, World Trade Center exposure, screened post-traumatic stress disorder, and baseline eGFR, CI and dementia were significantly associated with rapid eGFR decline (adjusted hazard ratio [aHR], 1.63 and 2.42, respectively; both P < 0.001) and faster annual eGFR decline. Findings were consistent across all sensitivity analyses. In addition, 248 (4%) individuals developed incident CKD. Both baseline CI (aHR, 1.72; P < 0.001) and dementia (aHR, 2.77; P = 0.010) were significantly associated with incident CKD. Conclusions Among middle-aged individuals without CKD, early-onset CI was independently associated with rapid eGFR decline and incident CKD. These findings warrant validation in other cohorts.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".