Cognitive Frailty and Its Risk Factors Among Patients With Chronic Kidney Disease Receiving Hemodialysis: A Cross-Sectional Study.
Mu-Hsing Ho, Pei-Chi Chen, Megan F Liu and 1 others
PMID 40698607WHAT IT FOUND
9% of hemodialysis patients had cognitive frailty, meaning physical frailty, cognitive functional decline and depressive symptoms together.
Malnutrition risk and physical inactivity were associated with it.
Key findings
01Among 220 analysed hemodialysis patients, 9% had cognitive frailty, 46.8% had cognitive functional decline, 10% had physical frailty, and 52.3% had depressive symptoms.
02After adjustment for age, sex and years of receiving hemodialysis, being at risk of malnutrition (adjusted OR 12.405, 95% CI 3.29-46.81) and being physically inactive (adjusted OR 89.445, 95% CI 5.87-1363.93) were significantly associated with higher odds of cognitive frailty.
03Patients with cognitive frailty had lower physical activity (mean 258.3 METs-min) and lower nutritional scores (mean 10.7 MNA-SF) than patients without cognitive frailty (mean 1104.2 METs-min and mean 12.7 MNA-SF).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The study was done in one hospital-based hemodialysis centre, so it may not apply to other settings. Only 11.8% of patients were older than 65 years, and the mean age was 45.3 years, so it says little about older dialysis patients. The design was cross-sectional, so it cannot show whether malnutrition or physical inactivity led to cognitive frailty, or whether cognitive frailty led to them. The adjusted associations had wide confidence intervals, so the size of the effects is uncertain. Occupation and medication were not measured, so they may have confounded the nutrition and activity findings. Participants reported activities and symptoms over time, so recall bias is possible. There is no standardised measure for cognitive frailty, and this study used a definition requiring positive findings on all three assessments.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the adjusted odds ratios of 12.405 for malnutrition risk and 89.445 for physical inactivity as proof that these factors cause cognitive frailty. The study was cross-sectional, and the confidence intervals were wide, so it cannot show direction or causality.