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Published on: October 2, 2020
Cognitive Impairment and its Correlates in Chronic Kidney Disease Patients Undergoing Haemodialysis
Shijo John Joseph1, Samrat Singh Bhandari2, Sanjiba Dutta3
1Senior Resident, Department of Psychiatry, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Gangtok, Sikkim, India.
Insights
Cognitive impairment is common in dialysis patients, affecting 44% and linked to depression, education, and socioeconomic status. Early identification is crucial for better treatment decisions.
Area of Science:
- Nephrology
- Neurology
- Psychiatry
Background:
- Cognitive impairment (CI) is prevalent in Chronic Kidney Disease (CKD) patients undergoing hemodialysis (HD).
- CI can negatively impact treatment adherence, quality of life, and is often exacerbated by depression.
- Understanding CI's prevalence and contributing factors in HD patients is critical.
Purpose of the Study:
- To determine the prevalence of CI in hemodialysis patients.
- To identify socio-demographic and patient-related variables associated with CI.
- To explore the relationship between depression and cognitive function in this population.
Main Methods:
- Fifty hemodialysis patients were assessed using the Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9).
- Descriptive statistics were used for socio-demographic and clinical variables.
- Chi-square and Kruskal-Wallis tests analyzed associations between variables.
Main Results:
- 44% of patients exhibited cognitive impairment, and 42% had depression.
- Education level and socioeconomic status significantly correlated with cognitive domains (recall, orientation, global score).
- Dialysis duration showed a negative correlation with cognition; depression was significantly linked to cognitive deficits.
Conclusions:
- Cognitive impairment is highly prevalent in hemodialysis patients.
- Factors such as education, socioeconomic status, dialysis duration, and depression significantly influence CI.
- Early CI detection is essential for tailored patient management and improved outcomes.
Background:
Cognitive Impairment (CI) has been found to be quite common amongst patients with Chronic Kidney Disease (CKD) undergoing haemodialysis (HD). The presence of these deficits could affect patient's adherence to diet regimens, treatment and also reduce their Quality of Life. The presence of depression in such patients can further lead to CI. We wanted to assess the prevalence of CI in CKD patients undergoing haemodialysis, socio-demographic and patient related variables affecting CI, and also the relationship between depression and cognition.
Methods:
Fifty patients undergoing haemodialysis from two dialysis units were assessed. The Montreal Cognitive Assessment (MoCA) scale and Patient Health Questionnaire-9 (PHQ-9) were administered to patients. Descriptive analysis was done for the socio-demographic and clinical variables. Chi square test was used to find the association between the categorical data. Kruskal-Wallis test was used to determine the association between categorical and quantitative variables.
Results:
Mean age of patient was 50.32 (±12.4) years. Mean duration of dialysis was 18.8 (±15.11) months. The prevalence of depression in the patients was 42%. Cognitive impairment was present in 44% of the patients. There was a significant relationship between education level and recall (χ2=31.7, df=12, p=.002) as well as orientation (χ2=29.78, df=8, p=.000) domains of cognition. Also, there was a significant relationship between socio-economic status and global cognition score (χ2=81.13, df=48, p=.002). There was a negative correlation between duration of dialysis and cognition. Significant relationships were found between depression and various cognitive domains.
Conclusions:
The prevalence of CI in haemodialysis patients is high. It is also affected by factors such as education level, socio-economic status, duration of dialysis and presence of depression. Insight into CI is essential for its early identification during the course of illness, so that patient precise treatment decisions can be made.
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