PREVALENCE AND PATTERN OF COGNITIVE IMPAIRMENT IN PATIENTS ON MAINTENANCE HEMODIALYSIS

Abstract

Background: Cognitive impairment is defined as a deficit in at least two aspects of cognitive function. The important aspects of cognition are attention, memory, language, visuo-spatial skills, and frontal/executive functions. Different pattern of cognitive impairment are seen in patients with CKD not on hemodialysis and those on hemodialysis. This study was conducted to know the prevalence and pattern of cognitive impairment in patients on chronic hemodialysis. Methods: This was a cross sectional study and was conducted at hemodialysis unit of Shifa International Hospitals, Islamabad. The study was performed over a period of six months and 250 hemodialysis patients were recruited through consecutive non probability sampling technique and were looked for cognitive impairment by using minimental state examination questionnaire translated in Urdu. Results: Out of 250 patients, mean age was 49 + 8.4 years. 92 (37%) were females and 158 (63%) were male patients. Education level of 133 (53%) patients were up to secondary school, 99 (40%) patients were higher secondary and 18 (7%) patients were masters. 43(17%) of patients were on hemodialysis for 4-6 months, 95(38%) of patients for 7-12 months, 78(31%) of patients for 13-24 months and 34(13%) of patients for> 24 months. The minimum MMSE score of patients were minimum of 26 and maximum of 30 with mean score of 28.5+0.811. Out of 250, 230(92%) patients had cognitive impairment. Mean scores in different MMSE domains like for orientation score was 9.5+0.497, for registration 2.9 +0.289, attention and calculation score was 4.738+ 0.5000, recall score was 2.8+0.352, language score was 8.5 +0.538. Conclusion: The study concluded that patients on hemodialysis have cognitive impairment and there is no relation of cognitive impairment with duration and frequency of hemodialysis, age , gender, level of education of patients. P value was insignificant.