Chronic kidney disease, atherosclerosis, and cognitive and physical function in the geriatric group of the National Health and Nutrition Survey 1999–2002

BackgroundThis study was designed to elucidate the relationship between chronic kidney disease (CKD), atherosclerotic complications, and the effects on functional performance in the elderly.MethodsA total of 2431 subjects aged 65 and above from the National Health and Nutrition Survey (NHANES) 1999–2002 were included to formulate a population-based observational study. A structural equation model (SEM) was constructed to validate the relationship between renal impairment, atherosclerotic complications, and cognitive and physical function.ResultsThe results showed that renal impairment was independently associated with physical and cognitive function after adjustment of potential confounding factors (B = −0.12, p = 0.02). Renal impairment was positively associated with atherosclerotic complications (B = 0.26, p < 0.001), which was in turn negatively associated with functional performance (B = −0.24, p < 0.001). Variance analysis showed that 57% of the differences in physical and cognitive function could be attributed to CKD, CKD-associated atherosclerosis, and other cardiovascular risk factors.ConclusionsCKD may have impacts on the cognitive and physical function either directly or indirectly via atherosclerotic complications.