Yaşlı Bireylerde Farklı Formüllerle Hesaplanan Glomerüler Filtrasyon Hızı İle Kognitif Fonksiyonların İlişkisi

Abstract

Ceyhan, F., The Relationship Between Glomerular Filtration Rate Calculated by Different Formulas and Cognitive Functions in Older Adults; Hacettepe University Faculty of Medicine, Department of Internal Medicine, Specialty Thesis; Ankara, 2025. The prevalence of cognitive impairment and chronic kidney disease (CKD) increases in older adults. The aim of this study was to investigate whether there is an association between cognitive impairment and CKD in older individuals and, if such a relationship exists, to determine which glomerular filtration rate (GFR) formula provides the most accurate clinical prediction. This study included 299 patients aged 65 years and older who were admitted to Geriatric Medicine Outpatient Clinic of Hacettepe University Faculty. Patients who had undergone both the Standardized Mini-Mental State Examination (S-MMSE) and the Quick Mild Cognitive Impairment–TR (QMCI-TR) tests during their routine visits were enrolled. GFR was calculated using creatinine-based formulas including FAS (Full Age Spectrum), BIS1 (Berlin Initiative Study 1), CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration), and MDRD (Modification of Diet in Renal Disease). The relationship between the patients’ cognitive test results and their GFR values was then analyzed. Participants’ ages ranged from 65 to 91 years, with a median age of 75. Of the participants, 55.9% were female. According to the Standardized Mini-Mental State Examination, cognitive impairment was observed in 33.1% (n=99) of participants, while QMCI-TR identified cognitive impairment in 33.8% (n=101). In the early stages of CKD, the combination of the FAS formula and S-MMSE provided a more sensitive approach for general cognitive screening. However, in patients with frailty or malnutrition, the combination of MDRD or BIS1 formulas with QMCI-TR was found to be more effective in detecting cognitive impairment associated with underlying geriatric syndromes. Based on these findings, early screening for cognitive impairment may enable detection in the preclinical or early stages of cognitive decline.