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Cognitive Decline in Hemodialysis Patients: A Cross-Sectional Study Using Addenbrooke's Cognitive Examination-III
Siri Chandana1, Jayakumar M1, Sandhya Suresh1
1Department of Nephrology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus
|October 17, 2025
Summary
Cognitive impairment affects nearly half of hemodialysis patients in South India, particularly impacting memory and attention. Early screening using ACE-III is recommended for timely interventions in chronic kidney disease care.
Area of Science:
- Nephrology
- Neurology
- Psychology
Background:
- Cognitive impairment (CI) is a common, often undiagnosed complication in patients undergoing maintenance hemodialysis (HD).
- Understanding the prevalence and patterns of CI in diverse populations like South India is crucial for effective management.
- The Addenbrooke's Cognitive Examination-III (ACE-III) offers a comprehensive tool for assessing cognitive function.
Purpose of the Study:
- To determine the prevalence and patterns of cognitive dysfunction among South Indian patients on maintenance hemodialysis.
- To identify clinical and sociodemographic factors associated with cognitive impairment in this population.
- To evaluate the utility of the ACE-III for screening cognitive impairment in HD patients.
Main Methods:
- A cross-sectional study involving 175 maintenance hemodialysis patients in Chennai, Tamil Nadu, India.
- Cognitive function was assessed using the Indian English version of the Addenbrooke's Cognitive Examination-III (ACE-III).
- Data on age, gender, education, dialysis duration, comorbidities, and hemoglobin levels were collected and analyzed.
Main Results:
- Cognitive impairment was identified in 46.9% (82 out of 175) of the patients, with ACE-III scores between 60-80.
- Lower cognitive scores significantly correlated with older age, lower educational attainment, and longer duration of dialysis (p<0.05).
- Memory and attention domains were most frequently affected by cognitive dysfunction.
Conclusions:
- Cognitive impairment is highly prevalent in the South Indian hemodialysis population, with significant associations with age, education, and dialysis duration.
- Routine screening with ACE-III can aid in the early detection of cognitive impairment in hemodialysis patients.
- Targeted interventions based on early detection can improve outcomes for cognitive dysfunction in chronic kidney disease patients undergoing dialysis.
Keywords:
ace-iiiaddenbrooke's cognitive examination-iii (ace-iii)chronic kidney diseasecognitive impairmenthaemodialysisindianeurocognitionMore Related Videos
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