ArticleBMC nephrology2024
Frailty, but not cognitive impairment, improves mortality risk prediction among those with chronic kidney disease-a nationally representative study.
Article in BMC nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association Between Frailty and Cognitive Impairment in Chronic Kidney Disease: A Systematic Review and Meta-Analysis.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026Pooled it
- Using the Difference Between Estimated Glomerular Filtration Rate by Cystatin C and Creatinine to Improve Mortality Risk Prediction in Elderly Patients With CKD in the HUNT Study.Kidney medicine · 2026Article
- Burden of geriatric and cognitive disorders and the impact of integrated care models on morbidity, functional decline, and health service utilization among older adults.Frontiers in medicine · 2026Article
- Chronic kidney Disease overall survival prediction model based on frailty index score: construction and validation using NHANES data.Renal failure · 2025Article
- The association between CKD and frailty in the FRASNET study: suggestion of a novel eGFR threshold as a key determinant of frailty in the elderly.Journal of nephrology · 2025Article
- Cognitive impairment in chronic kidney disease: mechanisms, clinical manifestations, and management strategies.Metabolic brain disease · 2025Review
- The association between frailty index and all-cause mortality in US individuals with kidney stones: mediation by systemic immune-inflammation (SII) index.Urolithiasis · 2025Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundThough older adults with chronic kidney disease (CKD) have a greater mortality risk than those without CKD, traditional risk factors poorly predict mortality in this population. Therefore, we tested our hypothesis that two common geriatric risk factors, frailty and cognitive impairment, and their co-occurrence, might improve mortality risk prediction in CKD.
methodsAmong participants aged ≥ 60 years from National Health and Nutrition Examination Survey (2011-2014), we quantified associations between frailty (physical frailty phenotype) and global/domain-specific cognitive function (immediate-recall [CERAD-WL], delayed-recall [CERAD-DL], verbal fluency [AF], executive function/processing speed [DSST], and global [standardized-average of 4 domain-specific tests]) using linear regression, and tested whether associations differed by CKD using a Wald test. We then tested whether frailty, global cognitive impairment (1.5SD below the mean), or their combination improved prediction of mortality (Cox models, c-statistics) compared to base models (likelihood-ratios) among those with and without CKD.
resultsAmong 3,211 participants, 1.4% were cognitively impaired, and 10.0% were frail; frailty and cognitive impairment co-occurrence was greater among those with CKD versus those without (1.2%vs.0.1%). Frailty was associated with worse global cognitive function (Cohen's d = -0.26SD,95%CI -0.36,-0.17), and worse cognitive function across all domains; these associations did not differ by CKD (p
conclusionsFrailty is associated with worse cognitive function regardless of CKD status. While CKD and frailty improved mortality prediction, cognitive impairment did not. Risk prediction tools should incorporate frailty to improve mortality prediction among those with CKD.
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