Urinary Protein Predicts Cognitive Decline

Small amounts of albumin in the urine strongly predict faster cognitive decline in older women.

When urinary albumin concentrations, at levels not traditionally considered clinically significant, are matched with creatinine levels in women, they can be used to foresee deterioration in those women's mental health.

In a study carried out at Brigham and Women's Hospital, (Boston, MA, USA), 1,200 female participants aged over 70 years, were tested for general cognition over a lengthy period. This included verbal and word memory, verbal fluency (speed in making word associations), and working and short-term memory. The participants with a urinary albumin-to-creatinine ratio of greater than 5 μg/mg at the start of the study experienced cognitive decline at a rate two to seven times faster in all cognitive measures than that attributed to aging alone over an average six years of follow-up.

Julie Lin, MD, author of the study, said, "The strongest association was seen with a decline in the verbal fluency score, which has been attributed to progressive small vessel disease in the brain, which supports the view that albuminuria is an early marker of diffuse vascular disease." The aging US population is at risk for cognitive decline and vascular disease. This simple, noninvasive screening for albumin in the urine as an independent predictor for subsequent cognitive decline may represent an important public health issue. The study was presented at the annual meeting of American Society of Nephrology held in Denver, CO, USA, November 16-21, 2010.

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