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Assessing Functional Cognition in People on Maintenance Hemodialysis Using Performance-Based Testing.

Urooj Khan1, Shlomit Rotenberg1,2, Jill I Cameron1,2

  • 1Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.

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Summary
This summary is machine-generated.

Functional cognitive impairment affects about half of patients on maintenance hemodialysis, impacting daily activities. Older age and minority ethnicity are key risk factors for this cognitive decline.

Keywords:
CKDchronic dialysiscognitiondementiahemodialysisquality of life

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Area of Science:

  • Nephrology
  • Neuroscience
  • Gerontology

Background:

  • Maintenance hemodialysis patients often struggle with daily tasks.
  • The link between functional limitations and cognitive impairment in this population is not well understood.
  • This study aimed to quantify functional cognitive impairment in hemodialysis patients using a performance-based assessment.

Purpose of the Study:

  • To estimate the prevalence of functional cognitive impairment in individuals undergoing maintenance hemodialysis.
  • To assess the correlation between a performance-based functional cognition test and traditional cognitive screening tools and self-report measures.
  • To identify predictors of functional cognitive impairment in this patient group.

Main Methods:

  • A cross-sectional study involving 105 hemodialysis patients in Toronto.
  • Utilized the University of California San Diego Performance-Based Skills Assessment-Brief (UPSA-B) for functional cognition assessment.
  • Administered the Montreal Cognitive Assessment (MoCA), Barthel Index, and Lawton-Brody IADL scale for comparison.

Main Results:

  • 54% of participants (n=56) showed functional cognitive impairment based on the UPSA-B.
  • Strong correlation found between UPSA-B and MoCA (r=0.67), weak correlations with Barthel Index (r=0.38) and IADL (r=0.39).
  • Older age and ethnic minority status were significant predictors of functional cognitive impairment.

Conclusions:

  • Functional cognitive impairment is highly prevalent in patients on maintenance hemodialysis.
  • Performance-based assessments are crucial for identifying cognitive deficits impacting daily functioning.
  • Cognitive rehabilitation strategies should be explored to improve functional outcomes in this population.