Abstract
The clinical epidemiological features of cognitive impairment in Chinese older adult patients undergoing hemodialysis are not clear, we aimed to identify the extent and patterns of cognitive impairment among those patients. We conducted a cross-sectional study of 613 hemodialysis patients aged 50 to 80 from 11 centers in Beijing. A neuropsychological battery of 11 tests covering domains of attention/processing speed, executive function, memory, language, and visuospatial function was applied, patients were classified as none, mild, or major cognitive impairment according to the fifth version of the Diagnostic and Statistical Manual of Mental Disorders criteria for cognitive impairment. Compared with Chinese population norms, 37.2% of the participants had mild cognitive impairment, 43.7% had major cognitive impairment. Memory and language were the most severe impaired domains in the mild cognitive impairment group, attention and visuospatial function domains were the most serious impaired domains in the major cognitive impairment group. Concomitant impairment across multiple cognitive domains was common. Factors associated with major cognitive impairment included age, education level, history of stroke and hypertension, dialysis vintage, and single-pool Kt/V. There is a high frequency of cognitive impairment in Chinese older adult hemodialysis patients, with varying severity and concomitant impairment across multiple domains.
Highlights
The clinical epidemiological features of cognitive impairment in Chinese older adult patients undergoing hemodialysis are not clear, we aimed to identify the extent and patterns of cognitive impairment among those patients
In the remaining 613 patients provided consent to participate in the full cognitive test battery, the mean age of the participants was 63.82 ± 7.14 years, 42.1% were women, 91.4% were married, and only 5.9% had less than six years of education
Impairment severity tended to differ across domains in the mild and major cognitive impairment groups, and co-occurrence of impairments across multiple cognitive domains occurred in 57.8% and 99.3% of patients in the mild and major cognitive impairment groups, respectively
Summary
The clinical epidemiological features of cognitive impairment in Chinese older adult patients undergoing hemodialysis are not clear, we aimed to identify the extent and patterns of cognitive impairment among those patients. A neuropsychological battery of 11 tests covering domains of attention/processing speed, executive function, memory, language, and visuospatial function was applied, patients were classified as none, mild, or major cognitive impairment according to the fifth version of the Diagnostic and Statistical Manual of Mental Disorders criteria for cognitive impairment. There is a high frequency of cognitive impairment in Chinese older adult hemodialysis patients, with varying severity and concomitant impairment across multiple domains. Previous studies in Chinese peritoneal dialysis patients showed that cognitive impairment, as defined by the Mini-Mental State Examination (MMSE), was present in 23 to 28%8,9. Since the MMSE does not include sensitive measures of attention and executive function, these studies may not have adequately demonstrated more subtle features of cognitive impairment in dialysis patients. No studies have systematically measured cognitive function across multiple domains in patients undergoing hemodialysis in China
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