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Frequency of and risk factors for poor cognitive performance in hemodialysis patients.
Neurology. 2013 Jan 29; 80(5):471-80.Neur

Abstract

OBJECTIVE

There are few detailed data on cognition in patients undergoing dialysis. We evaluated the frequency of and risk factors for poor cognitive performance using detailed neurocognitive testing.

METHODS

In this cross-sectional cohort study, 314 hemodialysis patients from 6 Boston-area hemodialysis units underwent detailed cognitive assessment. The neuropsychological battery assessed a broad range of functions, with established age-, sex-, and education-matched normative scores. Principal component analysis was used to derive composite scores for memory and executive function domains. Risk factors for each domain were evaluated using linear regression adjusting for age, sex, race, and education status. Analyses were repeated in those with Mini-Mental State Examination (MMSE) score ≥ 24.

RESULTS

Compared with population norms, patients on dialysis had significantly poorer executive function but not memory performance, a finding that persisted in the subgroup with MMSE score ≥ 24. In adjusted analyses, vascular risk factors and vascular disease were associated with lower executive function (p < 0.01).

CONCLUSIONS

There is a high frequency of poor cognitive performance in hemodialysis patients, primarily affecting executive function. Risk factors for worse executive function include vascular risk factors as well as vascular disease. Normal performance on the MMSE does not preclude impaired cognitive function, because individuals with MMSE score ≥ 24 also have a high frequency of poor cognitive performance.

Authors+Show Affiliations

Division of Nephrology, Tufts Medical Center, Boston, MA, USA. msarnak@tuftsmedicalcenter.orgNo 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
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23303848

Citation

Sarnak, Mark J., et al. "Frequency of and Risk Factors for Poor Cognitive Performance in Hemodialysis Patients." Neurology, vol. 80, no. 5, 2013, pp. 471-80.
Sarnak MJ, Tighiouart H, Scott TM, et al. Frequency of and risk factors for poor cognitive performance in hemodialysis patients. Neurology. 2013;80(5):471-80.
Sarnak, M. J., Tighiouart, H., Scott, T. M., Lou, K. V., Sorensen, E. P., Giang, L. M., Drew, D. A., Shaffi, K., Strom, J. A., Singh, A. K., & Weiner, D. E. (2013). Frequency of and risk factors for poor cognitive performance in hemodialysis patients. Neurology, 80(5), 471-80. https://doi.org/10.1212/WNL.0b013e31827f0f7f
Sarnak MJ, et al. Frequency of and Risk Factors for Poor Cognitive Performance in Hemodialysis Patients. Neurology. 2013 Jan 29;80(5):471-80. PubMed PMID: 23303848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frequency of and risk factors for poor cognitive performance in hemodialysis patients. AU - Sarnak,Mark J, AU - Tighiouart,Hocine, AU - Scott,Tammy M, AU - Lou,Kristina V, AU - Sorensen,Eric P, AU - Giang,Lena M, AU - Drew,David A, AU - Shaffi,Kamran, AU - Strom,James A, AU - Singh,Ajay K, AU - Weiner,Daniel E, Y1 - 2013/01/09/ PY - 2013/1/11/entrez PY - 2013/1/11/pubmed PY - 2013/3/22/medline SP - 471 EP - 80 JF - Neurology JO - Neurology VL - 80 IS - 5 N2 - OBJECTIVE: There are few detailed data on cognition in patients undergoing dialysis. We evaluated the frequency of and risk factors for poor cognitive performance using detailed neurocognitive testing. METHODS: In this cross-sectional cohort study, 314 hemodialysis patients from 6 Boston-area hemodialysis units underwent detailed cognitive assessment. The neuropsychological battery assessed a broad range of functions, with established age-, sex-, and education-matched normative scores. Principal component analysis was used to derive composite scores for memory and executive function domains. Risk factors for each domain were evaluated using linear regression adjusting for age, sex, race, and education status. Analyses were repeated in those with Mini-Mental State Examination (MMSE) score ≥ 24. RESULTS: Compared with population norms, patients on dialysis had significantly poorer executive function but not memory performance, a finding that persisted in the subgroup with MMSE score ≥ 24. In adjusted analyses, vascular risk factors and vascular disease were associated with lower executive function (p < 0.01). CONCLUSIONS: There is a high frequency of poor cognitive performance in hemodialysis patients, primarily affecting executive function. Risk factors for worse executive function include vascular risk factors as well as vascular disease. Normal performance on the MMSE does not preclude impaired cognitive function, because individuals with MMSE score ≥ 24 also have a high frequency of poor cognitive performance. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/23303848/Frequency_of_and_risk_factors_for_poor_cognitive_performance_in_hemodialysis_patients_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=23303848 DB - PRIME DP - Unbound Medicine ER -