Prevalence and patterns of cognitive impairment in adult hemodialysis patients: the COGNITIVE-HD study.
Abstract
Background: Mounting evidence indicates an increased risk of cognitive impairment in adults with end-stage kidney disease on dialysis, but the extent and pattern of deficits across the spectrum of cognitive domains are uncertain. Methods: We conducted a cross-sectional study of 676 adult hemodialysis patients from 20 centers in Italy, aiming to evaluate the prevalence and patterns of cognitive impairment across five domains of learning and memory, complex attention, executive function, language and perceptual-motor function. We assessed cognitive function using a neuropsychological battery of 10 tests and calculated test and domain z-scores using population norms (age or age/education). We defined cognitive impairment as a z-score ≤ -1.5. Results: Participants' median age was 70.9 years (range 21.6-94.1) and 262 (38.8%) were women. Proportions of impairment on each domain were as follows: perceptual-motor function 31.5% (150/476), language 41.2% (273/662), executive function 41.7% (281/674), learning and memory 42.2% (269/638), complex attention 48.8% (329/674). Among 474 participants with data for all domains, only 28.9% (n = 137) were not impaired on any domain, with 25.9% impaired on a single domain (n = 123), 17.3% on two (n = 82), 13.9% on three (n = 66), 9.1% on four (n = 43) and 4.9% (n = 23) on all five. Across patients, patterns of impairment combinations were diverse. Conclusions: In conclusion, cognitive impairment is extremely common in hemodialysis patients, across numerous domains, and patients often experience multiple deficits simultaneously. Clinical care should be tailored to meet the needs of patients with different types of cognitive impairment and future research should focus on identifying risk factors for cognitive decline.
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The prevalence of cognitive impairment in hemodialysis patients is approximately 70-80%, significantly higher than in individuals with normal kidney function.
“Previous studies including our own indicated that the prevalence of CI was ranged from 70 to 80%, which was significantly higher than those individuals with normal kidney function (Kurella Tamura et al., 2010; O’Lone et al., 2016; van Zwieten et al., 2018; Luo et al., 2020).”
From Association Between Sleep Disorders and Cognitive Impairment in Middle Age and Older Adult Hemodialysis Patients: A Cross-Sectional Study (2021) · cites this paper as van Zwieten et al., 2018
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- Authors
- van Zwieten, A., Wong, G., Ruospo, M., Palmer, S. C., Barulli, M. R., Iurillo, A., Saglimbene, V., Natale, P., Gargano, L., Murgo, M., Loy, C. T., Tortelli, R., Craig, J. C., Johnson, D. W., Tonelli, M., Hegbrant, J., Wollheim, C., Logroscino, G., Strippoli, G. F. M., & COGNITIVE-HD study investigators
- Affiliations
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney (AU)
- Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT)
- University of Otago (NZ)
- University of Bari Aldo Moro (IT)
- Diaverum Medical-Scientific Office, Lund, Sweden
- Translational Research Institute (AU)
- University of Calgary (CA)
- ORCID
- Venue
- Nephrology Dialysis Transplantation
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-11-22
- Volume
- 33
- Issue
- 7
- Pages
- 1197-1206
- ISSN
- 0931-0509 (ISSN-L)
- 1460-2385
- OpenAlex
- W2794955530
- Cited by
- 93
- References
- 64
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 14 · 2023: 13 · 2022: 10 · 2021: 10 · 2020: 12 · 2019: 4 · 2018: 2
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nephrology Dialysis Transplantation (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Funders
- Australian National Health
- Medical Research Council (APP 1107657, APP 1117534)
- University of Sydney (APP 1115259)
- Rutherford Discovery Fellowship
- New Zealand Royal Society
- Dementia Research Development Fellowship
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- cognitive impairment, hemodialysis, end-stage renal disease, prevalence, cognitive domain, executive function, complex attention, learning and memory, language, perceptual-motor function
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Renal Dialysis, Humans, Italy, Male, Middle Aged, Cohort Studies, Prevalence, Young Adult, Cognitive Dysfunction
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