![]() ![]() 19– 23 Although the Mini Mental State Exam (MMSE) is a time-efficient bedside test for cognitive function, 24 it may not detect cognitive impairments, when mild, in the general population or even in dialysis patients. It is useful in elderly patients however, its use is now expanding beyond that to different patient groups with different ages. The Montreal Cognitive Assessment (MoCA) 18 is a well-established tool created to detect cognitive impairment. 16 Cognitive impairment has also been found to be related to depression and difficulty following instructions. 9 Dialysis patients with cognitive impairment have worse survival than those with intact cognition, 15 as well as a worse quality of life. Lee et al 9 found that patients with varying degrees of severity of cognitive impairment are likely to go unnoticed and probably don’t voice any concerns. 12– 14ĭetecting cognitive impairments in dialysis patients is imperative. ![]() 12 The pathophysiology may be attributed to microinflammation, malnutrition, and uremic metabolites. 8– 11 Dialysis patients have a high burden of vascular disease, and cognitive impairment from cerebrovascular disease is common in patients undergoing either hemodialysis (HD) or peritoneal dialysis (PD). 3 Cognitive impairments have been found to involve multiple domains but described mainly as executive impairments. 5 Studies have found the prevalence of various degrees of cognitive impairment to range from 37–80% of patients on hemodialysis, 3, 4, 6, 7 with higher prevalence in the elderly. 1 Patients with end-stage renal disease (ESRD) requiring dialysis are at risk for cognitive impairment 2- 4 which can manifest in the pre-dialysis period. Cognitive impairment and dementia are common public health problems that have a huge burden on the healthcare system. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |