The effect of cognitive reserve on the risk of cognitive frailty in older patients receiving maintenance hemodialysis: a cross-sectional study.

IF 3.6 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Ning-Ning Xia, Hong-Ying Wang, Jing Liu
{"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.

认知储备对接受维持性血液透析的老年患者认知衰弱风险的影响:一项横断面研究。
背景:接受血液透析的老年患者可能由于生理退化和毒素积累而表现出认知衰弱的迹象。本研究旨在探讨老年维持性血液透析患者认知储备和认知衰弱的相关因素。方法:采用方便抽样的方法,于2023年2月至12月在江苏省血液净化中心抽取老年血液透析患者。收集一般资料、透析资料、生化指标、GDS-5评分、认知储备评分。将患者分为认知虚弱组(74例)和非认知虚弱组(163例)。采用logistic回归分析认知衰弱的相关因素,并采用ROC曲线分析评价认知储备评分对认知衰弱的判别能力。结果:共纳入237例接受维持性血液透析的老年患者(61%为男性,平均年龄70.8±8.2岁),其中31.2%表现出认知衰弱症状。Logistic回归分析显示,高龄、透析时间较长、GDS-5评分较高、认知储备评分较低、6个月内住院史与认知衰弱独立相关。结论:认知衰弱在老年维持性血液透析患者中普遍存在,且与多种因素有关。较低的认知储备分数与认知脆弱独立相关,并表现出识别受影响个体的理想辨别能力。然而,可以进行纵向研究来调查相关的潜在因果关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
European Geriatric Medicine
European Geriatric Medicine GERIATRICS & GERONTOLOGY-
CiteScore
6.70
自引率
2.60%
发文量
114
审稿时长
6-12 weeks
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信