{"title":"The effect of cognitive reserve on the risk of cognitive frailty in older patients receiving maintenance hemodialysis: a cross-sectional study.","authors":"Ning-Ning Xia, Hong-Ying Wang, Jing Liu","doi":"10.1007/s41999-025-01260-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Older patients undergoing hemodialysis may exhibit signs of cognitive frailty due to physiological degradation and the accumulation of toxins. This study aimed to explore the factors associated with both cognitive reserves and cognitive frailty in older patients receiving maintenance hemodialysis.</p><p><strong>Methods: </strong>Between February to December of 2023, older patients undergoing hemodialysis were selected from blood purification centers in Jiangsu Province, China, via convenience sampling. General data, dialysis data, biochemical indexes, GDS-5 scores, and cognitive reserve scores were collected. The patients were divided into two groups, namely, cognitively frail (74 patients) and non-cognitively frail (163 patients). Factors associated with cognitive frailty were analyzed via logistic regression, and ROC curve analysis was performed to evaluate the discriminative ability of cognitive reserve scores to identify cognitive frailty.</p><p><strong>Results: </strong>A total of 237 older patients receiving maintenance hemodialysis were included (61% male patients with a mean age of 70.8 ± 8.2 years), 31.2% of whom exhibited symptoms of cognitive frailty. Logistic regression showed that advanced age, longer dialysis durations, higher GDS-5 scores, lower cognitive reserve scores, and a history of inpatient admission within six months were independently associated with cognitive frailty. Each of these factors had a P value of < 0.05. The ROC curve analysis demonstrated that cognitive reserve scores had a strong discriminative ability to identify cognitive frailty, with an optimal cutoff value of 75.5 points, an AUC of 0.94, a sensitivity of 89.6%, and a specificity of 90.5%.</p><p><strong>Conclusion: </strong>Cognitive frailty is prevalent in older patients undergoing maintenance hemodialysis and is associated with multiple factors. Lower cognitive reserve scores were independently associated with cognitive frailty and demonstrated ideal discriminative ability to identify affected individuals. Nevertheless, longitudinal studies can be carried out to investigate the relevant underlying causal relationships.</p>","PeriodicalId":49287,"journal":{"name":"European Geriatric Medicine","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Geriatric Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s41999-025-01260-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Older patients undergoing hemodialysis may exhibit signs of cognitive frailty due to physiological degradation and the accumulation of toxins. This study aimed to explore the factors associated with both cognitive reserves and cognitive frailty in older patients receiving maintenance hemodialysis.
Methods: Between February to December of 2023, older patients undergoing hemodialysis were selected from blood purification centers in Jiangsu Province, China, via convenience sampling. General data, dialysis data, biochemical indexes, GDS-5 scores, and cognitive reserve scores were collected. The patients were divided into two groups, namely, cognitively frail (74 patients) and non-cognitively frail (163 patients). Factors associated with cognitive frailty were analyzed via logistic regression, and ROC curve analysis was performed to evaluate the discriminative ability of cognitive reserve scores to identify cognitive frailty.
Results: A total of 237 older patients receiving maintenance hemodialysis were included (61% male patients with a mean age of 70.8 ± 8.2 years), 31.2% of whom exhibited symptoms of cognitive frailty. Logistic regression showed that advanced age, longer dialysis durations, higher GDS-5 scores, lower cognitive reserve scores, and a history of inpatient admission within six months were independently associated with cognitive frailty. Each of these factors had a P value of < 0.05. The ROC curve analysis demonstrated that cognitive reserve scores had a strong discriminative ability to identify cognitive frailty, with an optimal cutoff value of 75.5 points, an AUC of 0.94, a sensitivity of 89.6%, and a specificity of 90.5%.
Conclusion: Cognitive frailty is prevalent in older patients undergoing maintenance hemodialysis and is associated with multiple factors. Lower cognitive reserve scores were independently associated with cognitive frailty and demonstrated ideal discriminative ability to identify affected individuals. Nevertheless, longitudinal studies can be carried out to investigate the relevant underlying causal relationships.
期刊介绍:
European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine.
The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.