Addressing cognitive impairment in drivers on hemodialysis through reaction time

End-stage kidney disease affects cognition and is associated with sleep disorders (SD), both increasing reaction time (RT) and impairing decision-making capacity.

To evaluate sleep disorders, age, dialysis duration, and education level on the RT of Brazilian drivers undergoing hemodialysis (HD) and the feasibility of the method employed.

We used tablet-based software to test the RT of 35 drivers undergoing HD and 32 controls. We did a clinical interview, examination, and chart review. The data were summarized and analyzed, which included conducting multiple linear regression. Significance was considered for p<0.05.

RT evaluation was well-received and effortless to carry out. Most patients were male (82.9%); the mean age was 52 years; two-thirds had been on HD for less than four years; 47.5% had 9.5 years or less of education; 14.3% had restless legs syndrome/Willis-Ekbom disease (RLS/WED); 68.6% showed a high likelihood of obstructive sleep apnea (OSA). HD patients showed higher RT than controls (p<0.001), and RT was positively associated with age (p<0.001). Less than 9.5 years of education and being on dialysis for over four years are associated with longer RT (p<0.05). Those with RLS/WED had shorter RT (p<0.001), age remained a significant predictor in the regression model, and patients on HD had longer RT than controls (p<0.001).

Testing the RT of drivers on HD in the clinic environment is fully feasible. Patients on HD had longer RT than controls. RLS/WED patients showed shorter RT, but, as age increases, the RT is longer.