Subclinical cognitive impairment in chronic kidney disease is associated with frailty and reduced quality of life

Abstract

Background Cognitive impairment (CI) in chronic kidney disease (CKD) is highly prevalent and is associated with multiple limitations to the patients who show a higher mortality, more days of hospitalisation and a lower quality of life. Frailty in CKD is associated with adverse health outcomes and is also highly prevalent. The aim of our study was to determine the prevalence and characteristics of CI and relate the findings to frailty, mobility, muscle strength, and Health-Related Quality of Life (HRQoL). Methods Non-dialysis patients with CKD-Stages 3–5 were prospectively evaluated for inclusion. Excluded were patients with other cognitive disorders; signs of overt uremic encephalopathy; severe infection and hyponatremia. All patients underwent psychometric testing (5 different tests), assessment of mobility, strength, frailty and evaluation of HRQoL. Based on the number of pathological psychometric test results we established 2 different definitions of CI: subclinical uremic encephalopathy (SUE1: one pathological test; SUE2: two or more pathological test results). Results Sixty-two patients were included [median age 66 (IQR 57–75); male 55%]. Most patients had CKD-Stage 3 (3: 48%; 4: 32%; 5: 19%). CI was highly prevalent (SUE1: 60%; SUE2: 42%) and associated to a higher risk of falls (pathological Tandem-Gait-Test; SUE 1: 50% vs. 16%, P = 0.023; SUE2: 69% vs. 15%, P = 0.001), lower muscle strength (SUE 2-pathological: 39% vs. 7%, P = 0.008), frailty (SUE1: 59% vs. 28%, P = 0.038; SUE2: 67% vs. 33%, P = 0.028) and HRQoL. Conclusion CI is highly prevalent in non-dialysis CKD-patients. Even mild CI is associated with a decrease in mobility, muscle strength, HRQoL and frailty.

Subclinical cognitive impairment in chronic pancreatitis is associated with reduced mobility and quality of life

“…The association of SCI with impaired mobility and a higher risk of falls has formerly been demonstrated in other metabolic encephalopathies ( 13 , 33 ). In line, patients with SCI in this study reported twice as many falls than patients without SCI in the year before inclusion (24% vs 12%).…”

“…Because there is no adequately comparable previous study or any form of definition of SCI in patients with CP, the aim was to find a simple definition that identifies patients who already present negative aspects associated with cognitive impairment (lower QoL, restrictions in mobility and balance). Furthermore, the same definition has been used in another study on metabolic encephalopathies before and could also demonstrate similar restrictions ( 13 ). Another important reason for this approach (with 1 pathological test as a definition for SCI) was that the potential to prevent progressive cognitive decline as the associated negative outcome might be higher in patients with mild impairment.…”

Post-COVID syndrome and cognitive dysfunction in patients treated with hemodialysis

“…Когнітивна дисфункція у гемодіалізних пацієнтів асоціюється з низкою негативних наслідків, зокрема з погіршенням якості життя [44]. В той же час, з'являється все більше публікацій про негативний вплив ПКС на якість життя [44,45].…”

“…Когнітивна дисфункція у гемодіалізних пацієнтів асоціюється з низкою негативних наслідків, зокрема з погіршенням якості життя [44]. В той же час, з'являється все більше публікацій про негативний вплив ПКС на якість життя [44,45]. В нашому дослідженні наявність ПКС у пацієнтів, які лікуються ГД, асоціювалася з достовірним зниженням показників якості життя, зокрема зниження фізичного та психічного сумарних компонентів Висновки: Найпоширенішими симптомами ПКС були втома та слабкість (84%) аносмія (84%), біль у м'язах (81%) і втрата волосся (77%).…”

The need for a multi-disciplinary reflection about frailty and cognitive impairment in chronic kidney disease

“…The paper by Robin Greinert et al . [ 1 ] touches upon a topic that is increasingly attracting interest from different perspectives (e.g. neurology, nephrology, ethics), but that at the same time is still in need of more focused and deeper analysis.…”