Association Between Frailty and Cognitive Impairment in Chronic Kidney Disease: A Systematic Review and Meta-Analysis.
Hien Thi Bui, Renny Wulan Apriliyasari, Quyen Huong Quynh Bui and 1 others
PMID 42375109WHAT IT FOUND
Frail patients with chronic kidney disease had a 213% increase in likelihood of cognitive impairment compared with robust patients.
Prefrail patients also had higher likelihood. The review found an association, not proof of cause or prevention.
Key findings
01Frail patients with chronic kidney disease had a pooled odds ratio of 3.13 (95% CI 1.92 to 5.12) for cognitive impairment compared with robust patients, which the paper describes as a 213% increase.
02Prefrail patients with chronic kidney disease had a pooled odds ratio of 2.70 (95% CI 1.64 to 4.45) for cognitive impairment compared with patients without prefrailty.
03Among patients with chronic kidney disease and cognitive impairment, 42.70% were frail, and among patients with chronic kidney disease and frailty, 42% had cognitive impairment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were cross-sectional, and baseline cohort data were used, so the analysis cannot show that frailty caused cognitive impairment or that cognitive impairment caused frailty. Only 2 studies adjusted for covariates, so residual confounding from diabetes, hypertension, stroke, dialysis time, age, or other factors may remain. Heterogeneity was high (I^2 = 93.98%), and pooled estimates differed by region, frailty tool, and whether studies adjusted for covariates. Frailty and cognitive impairment were measured with different tools, including the MMSE, which has known limitations for mild cognitive impairment.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that frailty causes cognitive impairment or that screening prevents it. Most studies were cross-sectional, only 2 studies adjusted for confounding factors, and the review showed an association, not proof of a treatment effect.