The assessment of cognitive function in older adult patients with chronic kidney disease: an integrative review

Hannan, Mary; Steffen, Alana; Quinn, Lauretta; Collins, Eileen G.; Phillips, Shane A.

doi:10.1007/s40620-018-0494-2

Cited by 10 publications

(8 citation statements)

References 73 publications

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“…Among the several types of cognitive screening tests utilized in the clinical setting, MMSE was reportedly most commonly utilized 20 . In patients with CKD and those undergoing hemodialysis, MMSE was found to be less superior to the Montreal Cognitive Assessment (MoCA) to detect the cognitive impairment 21 , 22 .…”

Section: Discussionmentioning

confidence: 99%

Cerebral oxygenation and body mass index association with cognitive function in chronic kidney disease patients without dialysis: a longitudinal study

Ookawara

Sasabuchi

et al. 2022

Sci Rep

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In chronic kidney disease (CKD) patients, the prevalence of cognitive impairment increases with CKD progression; however, longitudinal changes in cognitive performance remain controversial. Few reports have examined the association of cerebral oxygenation with cognitive function in longitudinal studies. In this study, 68 CKD patients were included. Cerebral regional oxygen saturation (rSO2) was monitored. Cognitive function was evaluated using mini-mental state examination (MMSE) score. Clinical assessments were performed at study initiation and 1 year later. MMSE score was higher at second measurement than at study initiation (p = 0.022). Multivariable linear regression analysis showed that changes in MMSE were independently associated with changes in body mass index (BMI, standardized coefficient: 0.260) and cerebral rSO2 (standardized coefficient: 0.345). This was based on clinical factors with p < 0.05 (changes in BMI, cerebral rSO2, and serum albumin level) and the following confounding factors: changes in estimated glomerular filtration rate, hemoglobin level, proteinuria, salt and energy intake, age, presence of diabetes mellitus, history of comorbid cerebrovascular disease, and use of renin–angiotensin system blocker. Further studies with a larger sample size and longer observational period are needed to clarify whether maintaining BMI and cerebral oxygenation improve or prevent the deterioration of cognitive function.

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Section: Discussionmentioning

confidence: 99%

Cerebral oxygenation and body mass index association with cognitive function in chronic kidney disease patients without dialysis: a longitudinal study

Ookawara

Sasabuchi

et al. 2022

Sci Rep

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“…[5][6][7] Chronic kidney disease leads to hypertension, anemia, vascular dysfunction, uremia, proteinuria, systemic inflammation, and oxidative stress that are associated with cognitive impairment. 8,9 Cognitive impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions which is a common problem affecting CKD patients. 10 The number of people living with severe cognitive impairment globally was 50 million in 2015.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Impairment and Associated Factors Among Chronic Kidney Disease Patients: A Comparative Cross-Sectional Study

Gela¹,

Getu²,

Adane³

et al. 2021

NDT

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Background: Cognitive impairment is one of the public health problems affecting 50 million people in the world. Chronic kidney disease (CKD) patients are at high risk to develop cognitive impairment which leads to poor quality of life, difficulty in adhering to medications, increased risk of mortality, and health resource utilization. However, there is no study done on the prevalence of cognitive impairment and associated factors among chronic kidney disease patients in Ethiopia. Objective: This study aimed to assess the prevalence of cognitive impairment and associated factors among chronic kidney disease patients at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020, Northwest Ethiopia, 2020. Methods: An institution-based comparative cross-sectional study was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals in 2020. A systematic random sampling technique was used to select the study participants. Data were collected using standard tools. Data were checked for its completeness and entered into Epi data version 3.0 then exported into STATA 14. Multi-variable logistic regression analysis was employed to identify associated factors of cognitive impairment among CKD patients, and variables having a p-value of ≤0.05 were declared as significant. Results: In this study, 116 CKD patients and 116 age, sex, and educational level matched controls were included with a response rate of 100%. The prevalence of cognitive impairment was 49.1% [95% CI (40%, 58.3%)] among CKD patients and 28.4% [95% CI (20.9%, 37.5%)] among controls. Independent predictors of cognitive impairment among CKD patients were estimated glomerular filtration (eGFR) <60mL/min/m 2 [AOR=3.9, 95% CI (1.1-14.74)], proteinuria [AOR=6.0, 95% 3)], age greater than 65 years [AOR=4.0, 95% CI (1.12-14.64)], and educational level of grade 8 and less [AOR= 4.7,]. Conclusion:The prevalence of cognitive impairment among CKD patients was higher than healthy controls. Cognitive impairment was higher among CKD patients with eGFR <60mL/ min/m 2 , proteinuria, educational level of grade 8 and less, and age greater than 65 years. Therefore, there is a need to have a regular evaluation and follow-up of CKD patients for cognitive impairment.

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“…Kidney function and the type of associated replacement therapy are associated with cognitive impairment [34][35][36][37]. Previous studies have found that cognitive impairment can decline when patients start hemodialysis [38][39][40], and in our study, 61% of the patients were on hemodialysis.…”

Section: Discussionmentioning

confidence: 45%

Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests

et al. 2021

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Background: Uremic encephalopathy is defined as cerebral dysfunction due to toxin accumulation in patients with chronic kidney disease (CKD). This condition is characterized by subtle to florid symptoms, and its clinical course is always progressive when untreated but partially reversible with renal replacement therapy. While no test exists to measure subclinical uremic encephalopathy, two tests have been validated to measure minimal hepatic encephalopathy: the critical flicker frequency (CFF) test and the psychometric hepatic encephalopathy score (PHES). Objective: To use CFF and PHES to measure the prevalence of cerebral dysfunction in individuals with CKD. Methods: This cross-sectional study included a total of 69 patients with stage-5 CKD. Cutoff points for minimal encephalopathy were established using existing clinical guidelines: 39 Hz for CFF and < À4 for PHES. All participants were also screened for cognitive function and depression. Results: Eighteen cases (26.1%) of cerebral dysfunction linked to uremic encephalopathy were detected with CFF, while twelve (17.4%) were detected by PHES; only six cases (8.7%) were diagnosed by both methods. Half of the cases (50%) had diabetes, and 61% were on hemodialysis. Cognitive function scores did not differ significantly between those receiving dialysis, hemodialysis, or no renal replacement therapy. Conclusions: It is essential to identify cerebral dysfunction when uremic encephalopathy is in early subclinical stages to reduce preventable events as traffic and work accidents.

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The assessment of cognitive function in older adult patients with chronic kidney disease: an integrative review

Cited by 10 publications

References 73 publications

Cerebral oxygenation and body mass index association with cognitive function in chronic kidney disease patients without dialysis: a longitudinal study

Cerebral oxygenation and body mass index association with cognitive function in chronic kidney disease patients without dialysis: a longitudinal study

Cognitive Impairment and Associated Factors Among Chronic Kidney Disease Patients: A Comparative Cross-Sectional Study

Evaluation of cerebral dysfunction in patients with chronic kidney disease using neuropsychometric and neurophysiological tests

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