{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T02:55:56Z","timestamp":1790564156981,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82401694"],"award-info":[{"award-number":["82401694"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020771","name":"Natural Science Foundation for Young Scientists of Shanxi Province","doi-asserted-by":"publisher","award":["202303021212339"],"award-info":[{"award-number":["202303021212339"]}],"id":[{"id":"10.13039\/501100020771","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013091","name":"Science and Technology Major Project of Guangxi","doi-asserted-by":"publisher","award":["2024AB33319"],"award-info":[{"award-number":["2024AB33319"]}],"id":[{"id":"10.13039\/501100013091","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013091","name":"Science and Technology Major Project of Guangxi","doi-asserted-by":"publisher","award":["2024JJH140474"],"award-info":[{"award-number":["2024JJH140474"]}],"id":[{"id":"10.13039\/501100013091","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n The association between kidney function and dementia remains inconsistent across studies, and its relationship in older adults is unclear. This study aimed to investigate the longitudinal associations between kidney dysfunction, assessed by estimated glomerular filtration rate (eGFR) and albuminuria, and cognitive impairment (CI) in a national cohort of Chinese older adults.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We included individuals aged \u2265\u200965\u2009years from the 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cognitive function was assessed using the Chinese version of the Mini\u2010Mental State Examination (MMSE). Kidney function was evaluated by eGFR (CKD\u2010EPI equation) and the urinary albumin\u2010to\u2010creatinine ratio (ACR), classified by KDIGO categories and quartiles. Multivariable logistic regression models were used to assess cross\u2010sectional (\n n<\/jats:italic>\n \u2009=\u20093364) and prospective (\n n<\/jats:italic>\n \u2009=\u20091195) associations, controlling for sociodemographic and clinical confounders. The false discovery rate was controlled for multiple comparisons.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In cross\u2010sectional analysis, both lower eGFR and higher ACR were independently associated with higher odds of prevalent CI. Prospectively, over a 3\u2010year follow\u2010up, 143 of 1195 cognitively normal participants developed CI. Compared to those with normal kidney function, participants with impaired (eGFR\u2009<\u200960\u2009mL\/min\/1.73\u2009m\n 2<\/jats:sup>\n ) kidney function had a significantly higher risk of incident CI (OR\u2009=\u20091.744, 95% CI: 1.162\u20132.616). Similarly, elevated ACR (categories A2 and A3) was associated with increased incident CI risk (A2: OR\u2009=\u20091.801, 95% CI: 1.111\u20132.920; A3: OR\u2009=\u20092.650, 95% CI: 1.541\u20134.557).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Impaired kidney function, indicated by reduced eGFR and elevated ACR, is independently associated with an increased risk of cognitive impairment in older adults. These findings support integrating cognitive screening into the clinical management of elderly patients with chronic kidney disease.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ggi.70859","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T02:40:51Z","timestamp":1790563251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Kidney Function and Risk of Cognitive Impairment Among Chinese Older Adults"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7254-0100","authenticated-orcid":false,"given":"Xin","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology, Shanxi Bethune Hospital Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0809-4542","authenticated-orcid":false,"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health Shanxi Medical University, Key Laboratory of Coal Environmental Pathogenicity and Prevention, Ministry Education Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1685-3387","authenticated-orcid":false,"given":"Zhigang","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Research Center for Neurological Diseases of Guangxi Province Guilin Medical University Guilin China"},{"name":"Key Laboratory of Environmental Exposomics and Entire Lifecycle Health of Guangxi Province Guilin Medical University Guilin China"},{"name":"Key Laboratory of Brain and Cognition of Guangxi Province Guilin Medical University Guilin China"},{"name":"Key Laboratory of Diabetic Systems Medicine of Guangxi Province Guilin Medical University Guilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5146-5276","authenticated-orcid":false,"given":"Xiaolei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shanxi Bethune Hospital Third Hospital of Shanxi Medical University, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital Taiyuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"issue":"2","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"e105","DOI":"10.1016\/S2468-2667(21)00249-8","article-title":"Estimation of the Global Prevalence of Dementia in 2019 and Forecasted Prevalence in 2050: An Analysis for the Global Burden of Disease Study 2019","volume":"7","author":"Nichols E.","year":"2022","journal-title":"Lancet Public Health"},{"issue":"12","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"e661","DOI":"10.1016\/S2468-2667(20)30185-7","article-title":"Prevalence, Risk Factors, and Management of Dementia and Mild Cognitive Impairment in Adults Aged 60\u2009Years or Older in China: A Cross\u2010Sectional Study","volume":"5","author":"Jia L.","year":"2020","journal-title":"Lancet Public Health"},{"issue":"6","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/s12264-022-00836-7","article-title":"Biofluid Biomarkers of Alzheimer's Disease: Progress, Problems, and Perspectives","volume":"38","author":"Huang S.","year":"2022","journal-title":"Neuroscience Bulletin"},{"issue":"10","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"6074","DOI":"10.1038\/s41380-021-01073-6","article-title":"Physiological Clearance of Amyloid\u2010Beta by the Kidney and Its Therapeutic Potential for Alzheimer's Disease","volume":"26","author":"Tian D. Y.","year":"2021","journal-title":"Molecular Psychiatry"},{"issue":"9","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"5343","DOI":"10.1007\/s12035-023-03420-w","article-title":"Associations of Blood and Cerebrospinal Fluid A\u03b2 and Tau Levels With Renal Function","volume":"60","author":"Sun H. L.","year":"2023","journal-title":"Molecular Neurobiology"},{"issue":"6","key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1053\/j.ajkd.2020.03.015","article-title":"Albuminuria and Estimated GFR as Risk Factors for Dementia in Midlife and Older Age: Findings From the ARIC Study","volume":"76","author":"Scheppach J. B.","year":"2020","journal-title":"American Journal of Kidney Diseases"},{"issue":"1","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/s13195-023-01248-z","article-title":"Kidney Function, Albuminuria, and Their Modification by Genetic Factors and Risk of Incident Dementia in UK Biobank","volume":"15","author":"Yeh T. S.","year":"2023","journal-title":"Alzheimer's Research & Therapy"},{"issue":"6","key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1136\/jnnp-2022-330347","article-title":"Cognitive Performance Is Associated With Glomerular Filtration Rate in Patients With Chronic Kidney Disease: Results From the CKD\u2010REIN Cohort","volume":"94","author":"P\u00e9pin M.","year":"2023","journal-title":"Journal of Neurology, Neurosurgery, and Psychiatry"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.archger.2023.105157","article-title":"Evaluating the Effect of Kidney Function on Brain Volumes and Dementia Risk in the UK Biobank","volume":"116","author":"Huang X.","year":"2024","journal-title":"Archives of Gerontology and Geriatrics"},{"issue":"10","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1111\/jgs.13034","article-title":"Renal Dysfunction Contributes to Episodic Memory Deficits and Medial Temporal Atrophy in Alzheimer's Disease: A Pilot Study","volume":"62","author":"Ng A.","year":"2014","journal-title":"Journal of the American Geriatrics Society"},{"issue":"7","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.1002\/alz.12910","article-title":"Association of Impaired Kidney Function With Dementia and Brain Pathologies: A Community\u2010Based Cohort Study","volume":"19","author":"Wang S.","year":"2022","journal-title":"Alzheimer's & Dementia"},{"issue":"12","key":"e_1_2_13_13_1","doi-asserted-by":"crossref","DOI":"10.1111\/ene.16488","article-title":"Association of Dementia With Impaired Kidney Function and Plasma Biomarkers: A Population\u2010Based Study","volume":"31","author":"Wang N.","year":"2024","journal-title":"European Journal of Neurology"},{"issue":"1","key":"e_1_2_13_14_1","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.52387","article-title":"Association of Kidney Function With Development of Alzheimer Disease and Other Dementias and Dementia\u2010Related Blood Biomarkers","volume":"6","author":"Stocker H.","year":"2023","journal-title":"JAMA Network Open"},{"issue":"12","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1007\/s10654-022-00923-z","article-title":"Kidney Function and Risk of Dementia: Observational Study, Meta\u2010Analysis, and Two\u2010Sample Mendelian Randomization Study","volume":"37","author":"Kjaergaard A. D.","year":"2022","journal-title":"European Journal of Epidemiology"},{"issue":"23","key":"e_1_2_13_16_1","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1212\/WNL.0b013e31823b4765","article-title":"Chronic Kidney Disease, Cognitive Decline, and Incident Dementia: The 3C Study","volume":"77","author":"Helmer C.","year":"2011","journal-title":"Neurology"},{"issue":"4","key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/alzrt181","article-title":"Dementia in the Oldest Old: A Multi\u2010Factorial and Growing Public Health Issue","volume":"5","author":"Gardner R. C.","year":"2013","journal-title":"Alzheimer's Research & Therapy"},{"key":"e_1_2_13_18_1","first-page":"1","volume-title":"Encyclopedia of Gerontology and Population Aging","author":"Gu D.","year":"2022"},{"issue":"10","key":"e_1_2_13_19_1","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/0895-4356(88)90034-0","article-title":"A Chinese Version of the Mini\u2010Mental State Examination; Impact of Illiteracy in a Shanghai Dementia Survey","volume":"41","author":"Katzman R.","year":"1988","journal-title":"Journal of Clinical Epidemiology"},{"key":"e_1_2_13_20_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jhazmat.2024.133785","article-title":"Long\u2010Term Exposure to Fine Particulate Matter Constituents and Cognitive Impairment Among Older Adults: An 18\u2010Year Chinese Nationwide Cohort Study","volume":"468","author":"Qi J.","year":"2024","journal-title":"Journal of Hazardous Materials"},{"key":"e_1_2_13_21_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.scitotenv.2023.166534","article-title":"The Effects of Heatwave on Cognitive Impairment Among Older Adults: Exploring the Combined Effects of Air Pollution and Green Space","volume":"904","author":"Zhou W.","year":"2023","journal-title":"Science of the Total Environment"},{"issue":"19","key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa2102953","article-title":"New Creatinine\u2010 and Cystatin C\u2013Based Equations to Estimate GFR Without Race","volume":"385","author":"Inker L. A.","year":"2021","journal-title":"New England Journal of Medicine"},{"issue":"8","key":"e_1_2_13_23_1","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1093\/ndt\/gfab226","article-title":"Mild to Moderate Decrease in eGFR and Cognitive Decline in Older Adults","volume":"37","author":"Grasing M.","year":"2022","journal-title":"Nephrology, Dialysis, Transplantation"},{"issue":"4","key":"e_1_2_13_24_1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","journal-title":"Kidney International"},{"key":"e_1_2_13_25_1","doi-asserted-by":"crossref","first-page":"2765","DOI":"10.1002\/alz.12910","article-title":"Association of Impaired Kidney Function With Dementia and Brain Pathologies: A Community\u2010Based Cohort Study","volume":"19","author":"Wang S.","year":"2023","journal-title":"Alzheimers Dement"},{"key":"e_1_2_13_26_1","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.2147\/CIA.S134205","article-title":"Kidney Function and Cognitive Decline in an Oldest\u2010Old Chinese Population","volume":"12","author":"Bai K.","year":"2017","journal-title":"Clinical Interventions in Aging"},{"issue":"1","key":"e_1_2_13_27_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1186\/s12877-020-01789-0","article-title":"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\u2010Sectional Study","volume":"20","author":"Wu J. J.","year":"2020","journal-title":"BMC Geriatrics"},{"issue":"6","key":"e_1_2_13_28_1","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1111\/jgs.14750","article-title":"Albuminuria in Association With Cognitive Function and Dementia: A Systematic Review and Meta\u2010Analysis","volume":"65","author":"Georgakis M. K.","year":"2017","journal-title":"Journal of the American Geriatrics Society"},{"issue":"11","key":"e_1_2_13_29_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10112364","article-title":"Diabetes, Albuminuria and the Kidney\u2014Brain Axis","volume":"10","author":"Ariton D. M.","year":"2021","journal-title":"Journal of Clinical Medicine"},{"issue":"11","key":"e_1_2_13_30_1","doi-asserted-by":"crossref","DOI":"10.1111\/cns.70079","article-title":"Endothelial Dysfunctions in Blood\u2013Brain Barrier Breakdown in Alzheimer's Disease: From Mechanisms to Potential Therapies","volume":"30","author":"Yue Q.","year":"2024","journal-title":"CNS Neuroscience & Therapeutics"},{"issue":"6","key":"e_1_2_13_31_1","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s11011-020-00561-y","article-title":"Association Between Chronic Kidney Disease and Alzheimer's Disease: An Update","volume":"35","author":"Zhang C. Y.","year":"2020","journal-title":"Metabolic Brain Disease"},{"key":"e_1_2_13_32_1","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2022.830064","article-title":"Disentangling the Relationship Between Chronic Kidney Disease and Cognitive Disorders","volume":"13","author":"Kelly D. M.","year":"2022","journal-title":"Frontiers in Neurology"},{"key":"e_1_2_13_33_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.arr.2022.101762","article-title":"Association of Kidney Function and Brain Health: A Systematic Review and Meta\u2010Analysis of Cohort Studies","volume":"82","author":"Tang X.","year":"2022","journal-title":"Ageing Research Reviews"},{"issue":"3","key":"e_1_2_13_34_1","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1053\/j.ajkd.2022.07.013","article-title":"Association of Kidney Function Measures With Signs of Neurodegeneration and Small Vessel Disease on Brain Magnetic Resonance Imaging: The Atherosclerosis Risk in Communities (ARIC) Study","volume":"81","author":"Scheppach J. B.","year":"2023","journal-title":"American Journal of Kidney Diseases"},{"key":"e_1_2_13_35_1","doi-asserted-by":"crossref","DOI":"10.3390\/ijms25031755","article-title":"From Acute to Chronic: Unraveling the Pathophysiological Mechanisms of the Progression From Acute Kidney Injury to Acute Kidney Disease to Chronic Kidney Disease","volume":"25","author":"Yeh T. H.","year":"2024","journal-title":"International Journal of Molecular Sciences"},{"key":"e_1_2_13_36_1","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1080\/0886022X.2021.1915799","article-title":"Efficacy of Statins on Renal Function in Patients With Chronic Kidney Disease: A Systematic Review and Meta\u2010Analysis","volume":"41","author":"Zhao L.","year":"2021","journal-title":"Renal Failure"},{"key":"e_1_2_13_37_1","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1111\/jgs.19319","article-title":"Effects of Statins on Kidney Function in Older Adults","volume":"73","author":"Fravel M. A.","year":"2025","journal-title":"Journal of the American Geriatrics Society"},{"key":"e_1_2_13_38_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.jclinepi.2004.10.012","article-title":"Using Health Care Utilization Databases for Epidemiologic Research on Therapeutics","volume":"58","author":"Schneeweiss S.","year":"2005","journal-title":"Journal of Clinical Epidemiology"},{"key":"e_1_2_13_39_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.bbr.2025.115467","article-title":"Depression in Chronic Kidney Disease: Particularities, Specific Mechanisms and Therapeutic Considerations, a Narrative Review","volume":"483","author":"Lefr\u00e8re A.","year":"2025","journal-title":"Behavioural Brain Research"},{"key":"e_1_2_13_40_1","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.15561","article-title":"Cerebrovascular Pulsatility Index Is Higher in Chronic Kidney Disease","volume":"11","author":"Oh E. S.","year":"2023","journal-title":"Physiological Reports"}],"container-title":["Geriatrics & Gerontology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70859","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ggi.70859","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70859","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T02:40:57Z","timestamp":1790563257000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ggi.70859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,27]]},"references-count":39,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/ggi.70859"],"URL":"https:\/\/doi.org\/10.1111\/ggi.70859","archive":["Portico"],"relation":{},"ISSN":["1444-1586","1447-0594"],"issn-type":[{"value":"1444-1586","type":"print"},{"value":"1447-0594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,27]]},"assertion":[{"value":"2026-05-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70859"}}