Cognitive impairment burden in older and younger adults across the kidney transplant care continuum

Chu, Nadia M.; Chen, Xiaomeng; Gross, Alden L.; Garonzik-Wang, Jacqueline M; Norman, Silas P.; Mathur, Aarti; Abidi, Maheen Z.; Brennan, Daniel C.; Segev, Dorry L.; McAdams‐DeMarco, Mara

doi:10.1111/ctr.14425

Cited by 11 publications

(12 citation statements)

References 78 publications

(187 reference statements)

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“…Exercise has beneficial effects on cognitive function [ 41 ]. The incidence of cognitive impairment is low in the younger population, but cognitive impairment increases with age [ 42 , 43 ]. Previous research suggests that physical activity in youth may contribute to the development of healthy adult lifestyles, and physical activity appears to have long-term benefits on cognition, mental health, bone health, and sedentary behavior [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Normal pace walking is beneficial to young participants’ executive abilities

Zhang

Xiang

Shi

et al. 2022

BMC Sports Sci Med Rehabil

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Background Exercise can improve cognitive function. The impact of acute exercise on cognition is related to exercise intensity. This study aimed to explore whether normal walking had a beneficial effect on cognition. Methods Compared with standing still, thirty healthy young men walked on a treadmill at a normal pace, and completed the Stroop test. Near-infrared spectroscopy was used to monitor the hemodynamic changes of the prefrontal cortex during the entire experiment. Results Studies showed that normal walking did not stimulate higher average cerebral oxygen in the PFC, but the peak cerebral oxygen in cognitive tests during walking was higher (Stroop Word: 2.56 ± 0.43 and 3.80 ± 0.50, P < 0.01, Stroop Color: 2.50 ± 0.37 and 3.66 ± 0.59, P < 0.05, Stroop Color-Word: 4.13 ± 0.55 and 5.25 ± 0.66, P < 0.01, respectively), and better results were achieved in the Stroop Color-Word test, which was reflected in faster reaction times (49.18 ± 1.68 s, 56.92 ± 2.29 s, respectively, P < 0.001) and higher accuracies (46.19 ± 0.69, 44.15 ± 0.91, respectively, P = 0.018). Conclusion For healthy young people, even a normal walk is therefore good for cognition.

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Section: Discussionmentioning

confidence: 99%

Normal pace walking is beneficial to young participants’ executive abilities

Zhang

Xiang

Shi

et al. 2022

BMC Sports Sci Med Rehabil

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“…Executive function was assessed by subtracting the time to complete TMT‐A from TMT‐B (TMT‐B –TMT‐A), as previously reported 31,32 . Impairment in executive function was defined as 1.5 SD above the mean time to test completion from this cohort, as previously reported 33 …”

Section: Methodsmentioning

confidence: 99%

“…31,32 Impairment in executive function was defined as 1.5 SD above the mean time to test completion from this cohort, as previously reported. 33 [34][35][36] and ICD-10 codes (G30.0-G30.1, G31.0, G31.01, G31.09, G31.83, F01, F01.5, F01.50, F01.51, F03, F03.9, and F03.91) as described in prior studies. 1,35,[37][38][39][40]…”

Section: Cognitive Functionmentioning

confidence: 99%

Delirium, changes in cognitive function, and risk of diagnosed dementia after kidney transplantation

Chu

Bae

Chen

et al. 2022

American Journal of Transplantation

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Kidney transplant (KT) recipients with delirium, a preventable surgical complication, are likely to reap cognitive benefits from restored kidney function, but may be more vulnerable to longer‐term neurotoxic stressors post‐KT (i.e., aging, immunosuppression). In this prospective cohort study, we measured delirium (chart‐based), global cognitive function (3MS), and executive function (Trail Making Test Part B minus Part A) in 894 recipients (2009–2021) at KT, 1/3/6‐months, 1‐year, and annually post‐KT. Dementia was ascertained using linked Medicare claims. We described repeated measures of cognitive performance (mixed effects model) and quantified dementia risk (Fine & Gray competing risk) by post‐KT delirium. Of 894 recipients, 43(4.8%) had post‐KT delirium. Delirium was not associated with global cognitive function at KT (difference = −3.2 points, 95%CI: −6.7, 0.4) or trajectories post‐KT (0.03 points/month, 95%CI: −0.27, 0.33). Delirium was associated with worse executive function at KT (55.1 s, 95%CI: 25.6, 84.5), greater improvements in executive function <2 years post‐KT (−2.73 s/month, 95%CI: −4.46,−0.99), and greater decline in executive function >2 years post‐KT (1.72 s/month, 95%CI: 0.22, 3.21). Post‐KT delirium was associated with over 7‐fold greater risk of dementia post‐KT (adjusted subdistribution hazard ratio = 7.84, 95%CI: 1.22, 50.40). Transplant centers should be aware of cognitive risks associated with post‐KT delirium and implement available preventative interventions to reduce delirium risk.

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“…The neurocognitive deficits in the adult CKD population exacerbate comorbidities and contribute to a lower quality of life. The most frequently impaired cognitive domains in the adult CKD population include executive function, orientation, and attention (48). Multiple studies have reported increases in cognitive impairment with increasing age; however, even the younger kidney transplant candidate in the adult population has a relatively high burden of cognitive impairments compared to the average adult.…”

Section: Disease or Development: Delineating Risk Factors For Brain A...mentioning

confidence: 99%

“…Multiple studies have reported increases in cognitive impairment with increasing age; however, even the younger kidney transplant candidate in the adult population has a relatively high burden of cognitive impairments compared to the average adult. The conclusions from Chu et al (48) suggest that transplant centers consider screening kidney disease patients for global cognitive impairment throughout their clinical care regardless of age (48).…”

Section: Disease or Development: Delineating Risk Factors For Brain A...mentioning

confidence: 99%

Impact of Chronic Kidney Disease on Brain Structure and Function

Steinbach

Harshman

2022

Front. Neurol.

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Chronic kidney disease (CKD) affects more than 37 million American adults. Adult-onset CKD is typically attributed to acquired comorbidities such as aging, type II diabetes, and cardiovascular disease. Conversely, congenital abnormalities of the kidney and urinary tract are the most common cause of CKD in children. Both adult and pediatric patients with CKD are at risk for neurocognitive dysfunction, particularly in the domain of executive function. The exact mechanism for neurocognitive dysfunction in CKD is not known; however, it is conceivable that the multisystemic effects of CKD—including hypertension, acidosis, anemia, proteinuria, and uremic milieu—exert a detrimental effect on the brain. Quantitative neuroimaging modalities, such as magnetic resonance imaging (MRI), provide a non-invasive way to understand the neurobiological underpinnings of cognitive dysfunction in CKD. Adult patients with CKD show differences in brain structure; however, much less is known about the impact of CKD on neurodevelopment in pediatric patients. Herein, this review will summarize current evidence of the impact of CKD on brain structure and function and will identify the critical areas for future research that are needed to better understand the modifiable risk factors for abnormal brain structure and function across both pediatric and adult CKD populations.

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Cognitive impairment burden in older and younger adults across the kidney transplant care continuum

Cited by 11 publications

References 78 publications

Normal pace walking is beneficial to young participants’ executive abilities

Normal pace walking is beneficial to young participants’ executive abilities

Delirium, changes in cognitive function, and risk of diagnosed dementia after kidney transplantation

Impact of Chronic Kidney Disease on Brain Structure and Function

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