#3044 Cognitive functions in elderly and senile patients with arterial hypertension, depending on the presence of concomitant chronic kidney disease stage 3A and 3B

Abstract Background the frequent comorbidity of arterial hypertension (AH) and chronic kidney disease (CKD), each of which is a risk factor for cognitive impairment, determines the need to diagnose cognitive deficits in these multimorbid patients. Aims to assess the impact of concomitant CKD on cognitive functions (CF) in elderly and senile patients with AH. Materials and methods 330 patients ≥60 years old with АH were included and divided into 2 groups: (1)—without CKD (n = 110, mean age 76 [69.8; 82.3] years, 45.5% women), (2) —patients with CKD G3a/G3b (n = 220, mean age 81 [73;85] years, 53.6% women). All the patients underwent cognitive assessment including the Montreal Cognitive Assessment (MoCA), Mini-Mental Status Examination (MMSЕ), Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-cog), Digit Symbol Substitution Test (DSST), Verbal fluency test. Results patients with CKD G3a/G3b, compared to patients without CKD, had significantly lower MoCA (23 [21; 25] versus 24 [22; 26] points, respectively, P = 0.005) and MMSE (27 [25; 29] versus 28 [25.8; 29] points, respectively, P = 0.002) scores and significantly higher ADAS-cog score (14 [11; 18] versus 11 [9; 15] points, P < 0.001), worse letter fluency (11 [10; 13] versus 12 [11; 13] words, respectively, P < 0.001), and worse DSST score (20 [17; 23] versus 21.5 [19; 25], respectively, P < 0.001). Patients with CKD G3b compared G3a and without CKD had worse MoCА, MMSE, and ADAS-cog results. In the single-factor logistic regression analysis, there was significant association between decreased MMSE scores (≤23 points) and stage G3a and G3b CKD: (odds ratio [OR] 3.25, P = 0.048; and OR 5.53, P = 0.003, respectively). There was also an association between decreased MoCA scores (≤25 points) and CKD G3a and G3b: OR 1.97, P = 0.040 and OR 2.24, P = 0.016, respectively. Conclusion our results indicate an unfavorable effect of concomitant CKD stage G3a/G3b on the CF of elderly and senile patients with AH and a worsening of CF as the severity of CKD increases.