Urine Test May Predict Cognitive Decline

Albumin is a protein produced by the liver.  Low amounts of albumin in the urine, at levels not traditionally considered clinically significant, may strongly predict faster cognitive decline in older women. Julie Lin, from Brigham and Women's Hospital (Massachusetts, USA), and colleagues studied over 1,200 women, ages 70 years and older, enrolled in the Nurses' Health Study. Subjects were surveyed every two years for three cycles and tested for general cognition, verbal/word memory, verbal fluency (speed in making word associations), and working/short-term memory. The team found that those participants with a urinary albumin-to-creatinine ratio of more than 5 mcg/mg at the start of the study experienced cognitive decline at a rate 2 to 7 times faster in all cognitive measures than that attributed to aging alone over an average 6 years of follow-up. In particular, 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 team urges that: “Simple, non-invasive screening for albumin in the urine [is] an independent predictor for subsequent cognitive decline [and] may represent an important public health issue."