1. Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.
- Author
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Drew DA, Katz R, Kritchevsky S, Ix JH, Shlipak M, Newman AB, Hoofnagle A, Fried L, Gutiérrez OM, and Sarnak M
- Subjects
- Aged, Cognition, Cognitive Dysfunction physiopathology, Female, Fibroblast Growth Factor-23, Humans, Male, Aging blood, Body Composition, Cognitive Dysfunction blood, Fibroblast Growth Factors blood, Health
- Abstract
Background: Concentrations of fibroblast growth factor 23 (FGF-23), a hormone that regulates phosphorus and vitamin D metabolism, increase as kidney function declines. Excess fibroblast growth factor 23 may impact brain function through promotion of vascular disease or through direct effects on neuronal tissue., Methods: In the Healthy Aging and Body Composition Study, a longitudinal observational cohort of well-functioning older adults, intact serum FGF-23 was assayed in 2,738 individuals. Cognitive function was assessed at baseline and longitudinally at years 3, 5, and 8 by administration of the Modified Mini Mental State Examination (3MSE), a test of global cognitive function, and the Digit Symbol Substitution Test (DSST), a test primarily of executive function. The associations between FGF-23 and baseline cognitive function and incident cognitive impairment were evaluated using logistic and Poisson regression respectively, and were adjusted for demographics, baseline estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio, comorbidity, and other measures of mineral metabolism including soluble klotho., Results: The mean (SD) age was 74(3) years, with 51% female, and 39% black. The median (25th, 75th) FGF-23 concentration was 47 pg/mL (37, 60). Three hundred ninety-two individuals had prevalent cognitive impairment by the 3MSE and 461 by the DSST. There was no observed association between FGF-23 and baseline cognitive function for either cognitive test. There were 277 persons with incident cognitive impairment by 3MSE, and 333 persons with incident cognitive impairment by DSST. In fully adjusted models, each two-fold higher concentration of baseline FGF-23 was not associated with incident cognitive impairment by the 3MSE (IRR = 1.02[0.88, 1.19] fully adjusted model) or by the DSST (IRR = 0.98 [0.84, 1.15]. We saw no difference when analyses were stratified by eGFR greater than or less than 60 ml/min/1.73m2., Conclusion: Intact FGF-23 was not associated with baseline cognitive function or incident cognitive impairment in this cohort well-functioning older adults., Competing Interests: Dr. Gutierrez reports receiving grant funding and consulting fees from Akebia; grant funding and consulting fees from Amgen; grant funding from GSK; and consulting fees from QED Therapeutics. These interests do not alter our adherence to the PLOS ONE policies on sharing data and materials.
- Published
- 2020
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