BACKGROUND/AIMS: Up to 70% of hemodialysis patients over the age of 54 have relevant cognitive impairment. No standardized protocol for the evaluation and monitoring of this population is available today. We hypothesized that the dialysis procedure and the testing environment induce fluctuations of cognitive performance. METHODS: 26 hemodialysis patients were randomly tested using the Montreal Cognitive Assessment (MoCA) before, during and after hemodialysis and inside the dialysis room or alone in a separate room. Tests were performed at weekly intervals using five test variations to prevent learning effects. The Mini-Mental State Examination (MMSE) was performed as a reference test. RESULTS: MoCA scores significantly differed between the conditions: 'before hemodialysis' revealed the best MoCA score as compared to 'during hemodialysis' or 'after hemodialysis' (p = 0.013). During the combined condition 'before dialysis AND separate room', best performance was achieved (p < 0.001). The BP decline had no significant influence on cognitive performance, whereas the fluid shift showed a significant impact (p = 0.008). CONCLUSION: Cognitive performance in hemodialysis patients highly depends on the time point and testing environment. Therefore, we strongly suggest a standardization, using the MoCA before hemodialysis in a separate room, in order to make testing results of future research in this field comparable.
BACKGROUND/AIMS: Up to 70% of hemodialysis patients over the age of 54 have relevant cognitive impairment. No standardized protocol for the evaluation and monitoring of this population is available today. We hypothesized that the dialysis procedure and the testing environment induce fluctuations of cognitive performance. METHODS: 26 hemodialysis patients were randomly tested using the Montreal Cognitive Assessment (MoCA) before, during and after hemodialysis and inside the dialysis room or alone in a separate room. Tests were performed at weekly intervals using five test variations to prevent learning effects. The Mini-Mental State Examination (MMSE) was performed as a reference test. RESULTS: MoCA scores significantly differed between the conditions: 'before hemodialysis' revealed the best MoCA score as compared to 'during hemodialysis' or 'after hemodialysis' (p = 0.013). During the combined condition 'before dialysis AND separate room', best performance was achieved (p < 0.001). The BP decline had no significant influence on cognitive performance, whereas the fluid shift showed a significant impact (p = 0.008). CONCLUSION: Cognitive performance in hemodialysis patients highly depends on the time point and testing environment. Therefore, we strongly suggest a standardization, using the MoCA before hemodialysis in a separate room, in order to make testing results of future research in this field comparable.
Authors: Frances E Tiffin-Richards; Ana S Costa; Bernhard Holschbach; Rolf D Frank; Athina Vassiliadou; Thilo Krüger; Karl Kuckuck; Theresa Gross; Frank Eitner; Jürgen Floege; Jörg B Schulz; Kathrin Reetz Journal: PLoS One Date: 2014-10-27 Impact factor: 3.240
Authors: Christoph Schmaderer; Susanne Tholen; Anna-Lena Hasenau; Christine Hauser; Yana Suttmann; Siegfried Wassertheurer; Christopher C Mayer; Axel Bauer; Kostantinos D Rizas; Stephan Kemmner; Konstantin Kotliar; Bernhard Haller; Johannes Mann; Lutz Renders; Uwe Heemann; Marcus Baumann Journal: BMC Nephrol Date: 2016-10-26 Impact factor: 2.388
Authors: Susanne Angermann; Marcus Baumann; Dominik Steubl; Georg Lorenz; Christine Hauser; Yana Suttmann; Anna-Lena Reichelt; Robin Satanovskij; Franziska Sonntag; Uwe Heemann; Timo Grimmer; Christoph Schmaderer Journal: PLoS One Date: 2017-10-10 Impact factor: 3.240