#4279 ATTENTION AND EMOTIONAL COGNITIVE DEFICITS IN HEMODIALYSIS PATIENTS WITH NORMAL NEUROCOGNITIVE SCREENING TEST RESULTS: AN EGYPTIAN TRIPLE CENTER STUDY

Abstract

Abstract Background and Aims Cognitive impairment (CI) is common in hemodialysis (HD) patients. St. Louis University Mental Status (SLUMS) examination is a traditional cognitive assessment method that relies on a pen-and-paper format. SLUMS test is known to be one of the most sensitive tests to detect early CI. Its questions cover many functions, including memory, attention, orientation, and overall executive function. This study aimed to compare its results with computerized neurocognitive battery assessment for attention and emotional orientation functions. Method One hundred twenty HD patients from three different in-hospital HD centers in Dakhlia governorate, Egypt, were subjected to the 10-minute Arabic-validated version of the SLUMS test for early CI (11 questions- 30 points). The patients were below 60 years old with no previous functional or structural neurological disease history. According to the stated test interpretation scores, fifty patients were defined to have no CI. Those patients underwent computerized neurocognitive battery assessment for attention and emotional cognition accuracy and response times; their results were analyzed compared to another fifty age, gender, and educational level-matched healthy controls. Results Of the 120 SLUMS-tested patients, 50 patients (41.6%) had no CI, 43 with mild to moderate CI (36%), and 27 with severe CI (22.4%). The classified 50 HD patients with no CI results within the computerized neurocognitive battery assessment revealed significantly reduced scores than matched healthy controls in the number of true positive answers of continuous number performance test for attention (90.46±26.61 vs. 109.15±14.56, respectively, p <0.001), emotion recognition correct answers (29.44±5.54 vs. 31.41±4.65, respectively, p 0.02), emotional recognition response times by m.seconds (3482.76±2907.62 vs. 2907.62±732.98, respectively, p <0.001), and correct answers of emotion differentiation test (19.82±5.88 vs.23.77±3.63, respectively, p <0.001). HD patients' age was the only clinical correlate to emotional recognition and differentiation accurateness (rho = 0.442, p <0.001 and rho = 0.3, p 0.02, respectively). Conclusion Early detection of CI in HD patients is an important target to improve the patient's quality of life and functionality. The complete dependence on the known simple screening assessment may miss a significant portion of the early-affected personnel.