Mild cognitive impairment in older adults with pre‐dialysis patients with chronic kidney disease: Prevalence and association with physical function

Otobe, Yuhei; Hiraki, Koji; Hotta, Chiharu; Nishizawa, Hajime; Izawa, Kazuhiro P.; Taki, Yasuhiro; Imai, Naohiko; Sakurada, Tsutomu; Shibagaki, Yugo

doi:10.1111/nep.13173

Cited by 39 publications

(36 citation statements)

References 31 publications

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“…Despite the lack of distinction between the factors presented previously, the studies found high rates of cognitive impairment in the sample, ranging from 28.9%10 to 74.6% 2. The lowest index was found in the study with patients on peritoneal dialysis, with prevalence of higher education; however, six other papers5 , 9 , 11 , 12 , 15 , 17 presented a prevalence above 58% of cognitive impairment in the sample.…”

Section: Discussioncontrasting

confidence: 56%

“…We found out that age, education, basic diseases and being in renal replacement therapy may influence cognitive impairment;5 , 9 , 10 , 12 , 13 however, no significant differences were found between dialysis modalities in general scores 9. We also found that the etiology of cognitive impairment may not be entirely attributed to low rates of glomerular filtration11 , 12, demonstrating that albuminuria was associated with statistically significant worse performance 14. The results suggest that cognitive impairment in dialysis patients may not be fully reversible after transplantation 12…”

Section: Resultsmentioning

confidence: 66%

“…Only two studies presented the definition of what was understood by cognitive impairment, agreeing among themselves, explaining the term as an alteration in cognition in one or more domains, with preservation of functional and independent abilities, without prejudice to daily living activities 25 One of the studies does not define, but exemplifies that cognitive impairment would be a condition between expected cognitive decline for age and dementia 11Table 3 presents data with reference to study objectives, methods used, and limitations presented by authors about the study.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding studies that sought to estimate the prevalence of cognitive impairment in the population with CKD,2 , 5 , 9 , 11 - 13 the main finding is the high prevalence of cognitive impairment found in the samples. We found out that age, education, basic diseases and being in renal replacement therapy may influence cognitive impairment;5 , 9 , 10 , 12 , 13 however, no significant differences were found between dialysis modalities in general scores 9.…”

Section: Resultsmentioning

confidence: 99%

“…Studies that used MoCA as a tool for cognitive measurement for intervention/exposure strategies10 , 11 , 15 - 18 found that cognition is an important factor to improve patients' clinical condition, even without being directly related to quality of life. They point out that the reduction in walking speed; arterial stiffness and lacunar infarction are important predictors of cognitive decline.…”

Section: Resultsmentioning

confidence: 99%

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Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review

Amatneeks

Hamdan

2019

Braz. J. Nephrol.

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Introduction: There is evidence in the literature that cognitive impairment is more prevalent in individuals with chronic kidney disease (CKD) than in the general population. The Montreal Cognitive Assessment (MoCA) is an instrument with a good application profile for cognitive evaluation of patients with CKD-like impairments. The objective of this study is to perform a systematic review of MoCA use in the context of CKD. Method: The keywords "Montreal Cognitive Assessment", "Kidney Disease" and "Chronic Kidney Disease" were used to search the databases. The inclusion criteria were: a) empirical articles; b) approach to cognitive impairment in CKD; c) papers in Portuguese and English. Results: The studies were mostly cross-sectional, published in medical journals, with research carried out mostly in Europe. About 45% of the studies had samples of less than 150 participants and variations in the prevalence of cognitive impairment were found ranging from 28.9% to 74.6%. The cutoff point for the identification of the impairment presented variation between the studies. Discussion: The results' analysis demonstrates the need for more complete studies on MoCA scoring and adaptation in its different versions. We recommend to the health professionals who will use the results in the clinical setting that the interpretation of the results be made in the light of studies more related to the context lived by the patients. Conclusions: The instrument is efficient to be used in several stages and treatment modalities of the disease. We point to the need to adapt a cut-off point for the instrument in the different translations of the instrument.

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Section: Discussioncontrasting

confidence: 56%

Section: Resultsmentioning

confidence: 66%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review

Amatneeks

Hamdan

2019

Braz. J. Nephrol.

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Astrocytic aryl hydrocarbon receptor mediates chronic kidney disease‐associated mental disorders involving GLT1 hypofunction and neuronal activity enhancement in the mouse brain

Huang

Hung

Hsu

et al. 2022

Glia

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Chronic kidney disease (CKD)-associated mental disorders have been attributed to the excessive accumulation of hemodialysis-resistant indoxyl-3-sulfate (I3S) in the brain. I3S not only induces oxidative stress but is also a potent endogenous agonist of the aryl hydrocarbon receptor (AhR). Here, we investigated the role of AhR in CKD-induced brain disorders using a 5/6 nephrectomy-induced CKD mouse model, which showed increased I3S concentration in both blood and brain, anxiety and impaired novelty recognition, and AhR activation in the anterior cortex. GFAP + reactive astrocytes were increased accompanied with the reduction of glutamate transporter 1 (GLT1) on perineuronal astrocytic processes (PAPs) in the anterior cingulate cortex (ACC) in CKD mice, and these alterations were attenuated in both neural lineage-specific and astrocyte-specific Ahr conditional knockout mice (nAhrCKO and aAhrCKO). By using chronic I3S treatment in primary astrocytes and glia-neuron (GN) mix cultures to mimic the CKD brain microenvironment, we also found significant reduction of GLT1 expression and activity in an AhR-dependent manner. Chronic I3S treatment induced AhR-dependent pro-oxidant Nox1 and AhR-independent antioxidant HO-1 expressions. Notably, AhR mediates chronic I3S-induced neuronal activity enhancement and synaptotoxicity in GN mix, not neuron-enriched cortical culture.In CKD mice, neuronal activity enhancement was observed in ACC and hippocampal CA1, and these responses were abrogated by both nAhrCKO and aAhrCKO. Finally, intranasal AhR antagonist CH-223191 administration significantly ameliorated the GLT1/PAPs reduction, increase in c-Fos + neurons, and memory impairment in the CKD mice. Thus, astrocytic AhR plays a crucial role in the CKD-induced disturbance of neuron-astrocyte interaction and mental disorders.

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Sleep Disorders in Chronic Kidney Disease

De Santo

2023

Management of Chronic Kidney Disease

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Mild cognitive impairment in older adults with pre‐dialysis patients with chronic kidney disease: Prevalence and association with physical function

Abstract: The prevalence of MCI among older adults with pre-dialysis CKD was as high as 62.5%. The association between MCI and reduced gait speed supports the possible interaction between physical and cognitive functions and the need for early screening.

Cited by 39 publications

References 31 publications

Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review

Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review

Astrocytic aryl hydrocarbon receptor mediates chronic kidney disease‐associated mental disorders involving GLT1 hypofunction and neuronal activity enhancement in the mouse brain

Sleep Disorders in Chronic Kidney Disease

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