Association of cognitive impairment with the interaction between chronic kidney disease and depression: findings from NHANES 2011–2014

• Published in: BMC psychiatry Vol. 24; no. 1; pp. 312 - 12
• Main Authors: Zhou, Tong, Zhao, Jiayu, Ma, Yimei, He, Linqian, Ren, Zhouting, Yang, Kun, Tang, Jincheng, Liu, Jiali, Luo, Jiaming, Zhang, Heping
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24.04.2024; BioMed Central; BMC
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Brain research; Cardiovascular disease; Care and treatment; Chronic kidney disease; Chronic kidney failure; Cognition disorders; Cognitive ability; Cognitive Dysfunction - epidemiology; Cognitive impairment; Comorbidity; Complications and side effects; Creatinine; Cross-Sectional Studies; Dementia; Depression; Depression - complications; Depression - epidemiology; Depression - psychology; Depression, Mental; Diabetes; Epidemiology; Executive function; Female; Humans; Hypertension; Interaction; Kidney diseases; Male; Medical research; Medicine, Experimental; Memory; Mental depression; Mental disorders; Middle Aged; Nutrition Surveys; Older people; Patients; Prevention; Psychological aspects; Quality of life; Questionnaires; Regression analysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; Renal Insufficiency, Chronic - psychology; Risk factors; Sleep disorders; Sociodemographics; Surveys; United States - epidemiology; Variables; United States; China; United States > US; Depression; Chronic kidney disease; Interaction; Cognitive impairment
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-024-05769-1

Cognitive impairment (CoI), chronic kidney disease (CKD), and depression are prevalent among older adults and are interrelated, imposing a significant disease burden. This study evaluates the association of CKD and depression with CoI and explores their potential interactions. Data for this study were sourced from the 2011-2014 National Health and Nutritional Examination Survey (NHANES). Multiple binary logistic regression models assessed the relationship between CKD, depression, and CoI while controlling for confounders. The interactions were measured using the relative excess risk of interaction (RERI), the attributable proportion of interaction (AP), and the synergy index (S). A total of 2,666 participants (weighted n = 49,251,515) were included in the study, of which 700 (16.00%) had CoI. After adjusting for confounding factors, the risk of CoI was higher in patients with CKD compared to non-CKD participants (odds ratio [OR] = 1.49, 95% confidence interval [CI]:1.12-1.99). The risk of CoI was significantly increased in patients with depression compared to those without (OR = 2.29, 95% CI: 1.73-3.03). Furthermore, there was a significant additive interaction between CKD and depression in terms of the increased risk of CoI (adjusted RERI = 2.01, [95% CI: 0.31-3.71], adjusted AP = 0.50 [95% CI: 0.25-0.75], adjusted S = 2.97 [95% CI: 1.27-6.92]). CKD and depression synergistically affect CoI, particularly when moderate-to-severe depression co-occurs with CKD. Clinicians should be mindful of the combined impact on patients with CoI. Further research is needed to elucidate the underlying mechanisms and assess the effects specific to different CKD stages.