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Cognitive dysfunction and depression in adult kidney transplant recipients: baseline findings from the FAVORIT Ancillary Cognitive Trial (FACT).
J Ren Nutr 2012; 22(2):268-76.e1-3JR

Abstract

OBJECTIVE

Hyperhomocysteinemia and B-vitamin deficiency may be treatable risk factors for cognitive impairment and decline. Hyperhomocysteinemia, cognitive impairment, and depression are all common in individuals with kidney disease, including kidney transplant recipients. Accordingly, we assessed the prevalence of cognitive impairment and depressive symptoms in transplant recipients and their association with kidney function, plasma total homocysteine, and B-vitamin concentrations.

SETTING

Cross-sectional analysis of baseline data from the Folic Acid for Vascular Outcome Reduction In Transplantation (FAVORIT) Ancillary Cognitive Trial (FACT), which included 183 participants in FAVORIT who underwent detailed neuropsychological assessment before the study intervention.

RESULTS

The mean age was 54.0 ± 9.5 years (range: 7 to 386 months). Men comprised 55.2% of the cohort, and the mean time between the current transplant and cognitive testing was 7.0 ± 5.8 years. Twenty-four percent of participants reported neurological or psychiatric complaints, and 30% exhibited symptoms of mild to severe depression. Testing revealed evidence of significant and selective deficits in this population: 33% performed more than 1 standard deviation (SD) below normed means on a memory test, 58% fell lower than 1 SD below the norms on a test of attention and mental processing speed, and 33% to 42% fell lower than 1 SD below the norms on several tests of executive function. Lower estimated glomerular filtration rate and lower folate were associated with poorer performance on tests of memory and executive function.

CONCLUSIONS

These observations confirm previous reports of mood and cognitive impairments in adult kidney transplant recipients. Further research is needed to determine the benefit of B-vitamin supplementation and other interventions in this patient population.

Authors+Show Affiliations

Nutrition and Neurocognition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, USA. troen@agri.huji.ac.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

22153382

Citation

Troen, Aron M., et al. "Cognitive Dysfunction and Depression in Adult Kidney Transplant Recipients: Baseline Findings From the FAVORIT Ancillary Cognitive Trial (FACT)." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 22, no. 2, 2012, pp. 268-76.e1-3.
Troen AM, Scott TM, D'Anci KE, et al. Cognitive dysfunction and depression in adult kidney transplant recipients: baseline findings from the FAVORIT Ancillary Cognitive Trial (FACT). J Ren Nutr. 2012;22(2):268-76.e1-3.
Troen, A. M., Scott, T. M., D'Anci, K. E., Moorthy, D., Dobson, B., Rogers, G., ... Rosenberg, I. H. (2012). Cognitive dysfunction and depression in adult kidney transplant recipients: baseline findings from the FAVORIT Ancillary Cognitive Trial (FACT). Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 22(2), pp. 268-76.e1-3. doi:10.1053/j.jrn.2011.07.009.
Troen AM, et al. Cognitive Dysfunction and Depression in Adult Kidney Transplant Recipients: Baseline Findings From the FAVORIT Ancillary Cognitive Trial (FACT). J Ren Nutr. 2012;22(2):268-76.e1-3. PubMed PMID: 22153382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cognitive dysfunction and depression in adult kidney transplant recipients: baseline findings from the FAVORIT Ancillary Cognitive Trial (FACT). AU - Troen,Aron M, AU - Scott,Tammy M, AU - D'Anci,Kristen E, AU - Moorthy,Denish, AU - Dobson,Beverly, AU - Rogers,Gail, AU - Weiner,Daniel E, AU - Levey,Andrew S, AU - Dallal,Gerard E, AU - Jacques,Paul F, AU - Selhub,Jacob, AU - Rosenberg,Irwin H, AU - ,, Y1 - 2011/12/06/ PY - 2010/12/31/received PY - 2011/06/07/revised PY - 2011/07/11/accepted PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2012/6/19/medline SP - 268-76.e1-3 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 22 IS - 2 N2 - OBJECTIVE: Hyperhomocysteinemia and B-vitamin deficiency may be treatable risk factors for cognitive impairment and decline. Hyperhomocysteinemia, cognitive impairment, and depression are all common in individuals with kidney disease, including kidney transplant recipients. Accordingly, we assessed the prevalence of cognitive impairment and depressive symptoms in transplant recipients and their association with kidney function, plasma total homocysteine, and B-vitamin concentrations. SETTING: Cross-sectional analysis of baseline data from the Folic Acid for Vascular Outcome Reduction In Transplantation (FAVORIT) Ancillary Cognitive Trial (FACT), which included 183 participants in FAVORIT who underwent detailed neuropsychological assessment before the study intervention. RESULTS: The mean age was 54.0 ± 9.5 years (range: 7 to 386 months). Men comprised 55.2% of the cohort, and the mean time between the current transplant and cognitive testing was 7.0 ± 5.8 years. Twenty-four percent of participants reported neurological or psychiatric complaints, and 30% exhibited symptoms of mild to severe depression. Testing revealed evidence of significant and selective deficits in this population: 33% performed more than 1 standard deviation (SD) below normed means on a memory test, 58% fell lower than 1 SD below the norms on a test of attention and mental processing speed, and 33% to 42% fell lower than 1 SD below the norms on several tests of executive function. Lower estimated glomerular filtration rate and lower folate were associated with poorer performance on tests of memory and executive function. CONCLUSIONS: These observations confirm previous reports of mood and cognitive impairments in adult kidney transplant recipients. Further research is needed to determine the benefit of B-vitamin supplementation and other interventions in this patient population. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/22153382/Cognitive_dysfunction_and_depression_in_adult_kidney_transplant_recipients:_baseline_findings_from_the_FAVORIT_Ancillary_Cognitive_Trial__FACT__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(11)00156-7 DB - PRIME DP - Unbound Medicine ER -