Document Detail

Frequency of and risk factors for poor cognitive performance in hemodialysis patients.
MedLine Citation:
PMID:  23303848     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: There are few detailed data on cognition in patients undergoing dialysis. We evaluated the frequency of and risk factors for poor cognitive performance using detailed neurocognitive testing.
METHODS: In this cross-sectional cohort study, 314 hemodialysis patients from 6 Boston-area hemodialysis units underwent detailed cognitive assessment. The neuropsychological battery assessed a broad range of functions, with established age-, sex-, and education-matched normative scores. Principal component analysis was used to derive composite scores for memory and executive function domains. Risk factors for each domain were evaluated using linear regression adjusting for age, sex, race, and education status. Analyses were repeated in those with Mini-Mental State Examination (MMSE) score ≥ 24.
RESULTS: Compared with population norms, patients on dialysis had significantly poorer executive function but not memory performance, a finding that persisted in the subgroup with MMSE score ≥ 24. In adjusted analyses, vascular risk factors and vascular disease were associated with lower executive function (p < 0.01).
CONCLUSIONS: There is a high frequency of poor cognitive performance in hemodialysis patients, primarily affecting executive function. Risk factors for worse executive function include vascular risk factors as well as vascular disease. Normal performance on the MMSE does not preclude impaired cognitive function, because individuals with MMSE score ≥ 24 also have a high frequency of poor cognitive performance.
Mark J Sarnak; Hocine Tighiouart; Tammy M Scott; Kristina V Lou; Eric P Sorensen; Lena M Giang; David A Drew; Kamran Shaffi; James A Strom; Ajay K Singh; Daniel E Weiner
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2013-01-09
Journal Detail:
Title:  Neurology     Volume:  80     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-29     Completed Date:  2013-03-21     Revised Date:  2014-01-29    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  471-80     Citation Subset:  AIM; IM    
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MeSH Terms
Boston / epidemiology
Cognition Disorders / epidemiology*,  etiology*
Cross-Sectional Studies
Executive Function / physiology
Kidney Diseases / therapy
Linear Models
Memory / physiology
Mental Status Schedule
Middle Aged
Neuropsychological Tests
Principal Component Analysis
Reference Values
Renal Dialysis / adverse effects*
Risk Factors
Sensitivity and Specificity
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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