Urinary Biomarkers and Joint Cognition-Gait Trajectories: Findings from the Health, Aging, and Body Composition (ABC) Study: SA-PO1113

Background:Emerging urinary biomarkers can unlock new links between kidney tubular injury and cognitive-physical function.Methods:Using the Health ABC Study, we examined baseline urinary biomarkers—uromodulin, alpha-1 microglobulin (?1M), amino-terminal propeptide of type-III procollagen (PIIINP), neutrophil gelatinase-associated lipocalin (NGAL), interlukin-18 (IL-18), and kidney injury molecule-1 (KIM-1)—and joint cognition-gait trajectories among baseline high-function older adults. IL-18 and KIM-1 were measured in n=1902 participants; uromodulin, ?1M, PIIINP and NGAL were measured in a random subcohort (n=502). Group-based trajectory analysis of 20m usual gait speed and modified Mini-Mental State up to year 10 revealed three groups: high cognitive-physical function (Group 1), stable cognition/declining gait (Group 2), and rapid joint decline (Group 3).Results:After adjusting for covariates in separate models (Model-1A), higher ?1M (p=0.043) and KIM-1 (p=0.005) concentrations were related to worse trajectories (Table). Further adjustment for estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR) and c-reactive protein (CRP) (Model-1B) attenuated estimates; KIM-1 was not quite significant (p=0.059). In a fully adjusted model of all urinary markers (Model-2), only KIM-1 was significant (p=0.012), but the set of urinary biomarkers was jointly significant (p=0.022).Conclusion:KIM-1 was robustly related to cognitive-gait decline, and may link kidney tubular injury with aging-related functional outcomes.