Research on the cognitive frailty in maintenance hemodialysis patients_West China Medical Journal

Authors：

LUO Ying , LI Jie ,  YUAN Huaihong

Department of Nephrology and Institute of Kidney Diseases, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YUAN Huaihong, Email: yuanhuaihong@wchscu.cn

Keywords：

Maintenance hemodialysis; cognitive frailty; progress; review

DOI：

10.7507/1002-0179.202406179

Video：

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Abstract Full text Figures/Tables Video References Cited by

The coexistence of cognitive impairment and physical frailty in maintenance hemodialysis (MHD) patients is known as cognitive frailty. It has emerged as a novel complication in MHD patients and increases the risk of adverse outcomes such as falls, fractures, functional impairment and death. Timely intervention can delay or even reverse the development of cognitive frailty to dementia, thereby reducing the risk of adverse outcomes and improving the quality of life of patients. Based on this literature review method, this article summarizes the domestic and foreign research progress on the epidemiology, assessment tools, influencing factors and intervention measures of cognitive frailty in MHD patients, aiming to provide reference for clinical staff to carry out early screening and intervention of cognitive frailty in MHD patients.

Citation： LUO Ying, LI Jie, YUAN Huaihong. Research on the cognitive frailty in maintenance hemodialysis patients. West China Medical Journal, 2024, 39(7): 1131-1136. doi: 10.7507/1002-0179.202406179 Copy

1.	Beard JR, Officer A, de Carvalho IA, et al. The world report on ageing and health: a policy framework for healthy ageing. Lancet, 2016, 387(10033): 2145-2154.
2.	Wang L, Xu X, Zhang M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance. JAMA Intern Med, 2023, 183(4): 298-310.
3.	Engels N, de Graav GN, van der Nat P, et al. Shared decision-making in advanced kidney disease: a scoping review. BMJ Open, 2022, 12(9): e055248.
4.	王晗, 王莎莎, 胡树菁, 等. 慢性肾病病人衰弱与不良结局关系的系统综述. 护理研究, 2020, 34(9): 1497-1505.
5.	蒋婷婷, 单岩, 杜理平, 等. 老年血液透析患者认知衰弱现状及其与跌倒恐惧的相关性研究. 中国护理管理, 2020, 20(7): 1005-1009.
6.	陈管洁, 张海林, 尹丽霞, 等. 维持性血液透析患者认知功能障碍与衰弱的相关性. 护理学杂志, 2021, 36(6): 27-31.
7.	Panza F, D’Introno A, Colacicco AM, et al. Cognitive frailty: predementia syndrome and vascular risk factors. Neurobiol Aging, 2006, 27(7): 933-940.
8.	Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging, 2013, 17(9): 726-734.
9.	Woods AJ, Cohen RA, Pahor M. Cognitive frailty: frontiers and challenges. J Nutr Health Aging, 2013, 17(9): 741-743.
10.	Dartigues JF, Amieva H. Cognitive frailty: rational and definition from an (Ia.N.a./i.a.g.g.) international consensus group. J Nutr Health Aging, 2014, 18(1): 95.
11.	Ruan Q, Xiao F, Gong K, et al. Prevalence of cognitive frailty phenotypes and associated factors in a community-dwelling elderly population. J Nutr Health Aging, 2020, 24(2): 172-180.
12.	Mantovani E, Zucchella C, Schena F, et al. Towards a redefinition of cognitive frailty. J Alzheimers Dis, 2020, 76(3): 831-843.
13.	Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
14.	Abellan van Kan G, Rolland YM, Morley JE, et al. Frailty: toward a clinical definition. J Am Med Dir Assoc, 2008, 9(2): 71-72.
15.	Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J, 2001, 8(1): 323-336.
16.	Gobbens RJ, van Assen MA, Luijkx KG, et al. The tilburg frailty indicator: psychometric properties. J Am Med Dir Assoc, 2010, 11(5): 344-355.
17.	Kim M, Jeong MJ, Yoo J, et al. Calf circumference as a screening tool for cognitive frailty in community-dwelling older adults: the Korean frailty and aging cohort study (KFACS). J Clin Med, 2018, 7(10): 332.
18.	Montero-Odasso MM, Barnes B, Speechley M, et al. Disentangling cognitive-frailty: results from the gait and brain study. J Gerontol A Biol Sci Med Sci, 2016, 71(11): 1476-1482.
19.	Blumen HM, Allali G, Beauchet O, et al. A gray matter volume covariance network associated with the motoric cognitive risk syndrome: a multicohort MRI study. J Gerontol A Biol Sci Med Sci, 2019, 74(6): 884-889.
20.	Folstein MF, Folstein SE, Mchugh PR. “MiniMental State”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975, 12(3): 189-198.
21.	Nasreddine ZS, Phillips NA, Bédirian V, et al. The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 2005, 53(4): 695-699.
22.	Hughes CP, Berg L, Danziger WL, et al. A new clinical scale for the staging of dementia. Br J Psychiatry, 1982, 140(2): 566-572.
23.	Jeong JW, Kim KW, Lee DY, et al. A normative study of the revised hasegawa dementia scale: comparison of demographic influences between the revised hasegawa dementia scale and the mini-Mental status examination. Dement Geriatr Cogn Disord, 2007, 24(4): 288-293.
24.	Zalavadiya DD, Banerjee A, Sheth AM, et al. A comparative study of depression and associated risk factors among elderly inmates of old age homes and community of rajkot: a Gujarati version of the geriatric depression scale-short form (GDS-G). Indian J Community Med, 2017, 42(4): 204-208.
25.	Qiu Y, Li G, Wang X, et al. Prevalence of cognitive frailty among community-dwelling older adults: a systematic review and meta-analysis. Int J Nurs Stud, 2022, 125: 104112.
26.	陈管洁, 张海林, 尹丽霞, 等. 维持性血液透析患者认知衰弱的现状及影响因素分析. 中国护理管理, 2021, 21(8): 1179-1185.
27.	McAdams-DeMarco MA, Tan J, Salter ML, et al. Frailty and cognitive function in incident hemodialysis patients. Clin J Am Soc Nephrol, 2015, 10(12): 2181-2189.
28.	勾阳阳, 彭敏. 老年糖尿病病人认知衰弱研究进展. 护理研究, 2024, 38(4): 676-682.
29.	Brigola AG, Alexandre TDS, Inouye K, et al. Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults. Dement Neuropsychol, 2019, 13(2): 216-224.
30.	叶丽钦, 张海林, 周莹. 血液透析患者衰弱的相关研究进展. 中华护理杂志, 2018, 53(1): 99-104.
31.	刘春爱, 葛慧, 刘亚萍. 南京市维持性血液透析患者认知衰弱现状及其影响因素调查分析. 华南预防医学, 2023, 49(11): 1417-1420.
32.	Schietzel S, Kressig RW, Huynh-Do U. Screening of cognitive performance in kidney transplant recipients: a mini review. Front Nephrol, 2023, 3: 1238501.
33.	Seliger SL, Gillen DL, Longstreth WT, et al. Elevated risk of stroke among patients with end-stage renal disease. Kidney Int, 2003, 64(2): 603-609.
34.	Findlay MD, Thomson PC, Fulton RL, et al. Risk factors of ischemic stroke and subsequent outcome in patients receiving hemodialysis. Stroke, 2015, 46(9): 2477-2481.
35.	Sarnak MJ, Tighiouart H, Scott TM, et al. Frequency of and risk factors for poor cognitive performance in hemodialysis patients. Neurology, 2013, 80(5): 471-480.
36.	Tamura MK, Pajewski NM, Bryan RN, et al. Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults. Neurology, 2016, 86(13): 1208-1216.
37.	Nortley R, Korte N, Izquierdo P, et al. Amyloid β oligomers constrict human capillaries in Alzheimer’s disease via signaling to pericytes. Science, 2019, 365(6450): eaav9518.
38.	Findlay MD, Dawson J, Dickie DA, et al. Investigating the relationship between cerebral blood flow and cognitive function in hemodialysis patients. J Am Soc Nephrol, 2019, 30(1): 147-158.
39.	Wolfgram DF. Intradialytic cerebral hypoperfusion as mechanism for cognitive impairment in patients on hemodialysis. J Am Soc Nephrol, 2019, 30(11): 2052-2058.
40.	罗宝林. 老年慢性肾脏病患者认知衰弱现状及风险预测模型的构建. 广东汕头: 汕头大学, 2022.
41.	Giang LM, Weiner DE, Agganis BT, et al. Cognitive function and dialysis adequacy: no clear relationship. Am J Nephrol, 2011, 33(1): 33-38.
42.	蒋建新, 茹江丽, 焦宏宇, 等. 慢性肾衰竭病人血液透析后发生认知障碍的预测模型构建与验证. 护理研究, 2023, 37(21): 3838-3844.
43.	Meng Y, Wu HT, Niu JL, et al. Prevalence of depression and anxiety and their predictors among patients undergoing maintenance hemodialysis in northern China: a cross-sectional study. Ren Fail, 2022, 44(1): 933-944.
44.	易子涵, 邹兆华, 程新杰, 等. 维持性血液透析患者认知衰弱的现状及影响因素分析. 中国血液净化, 2024, 23(4): 273-277.
45.	Poursalehi D, Lotfi K, Saneei P. Adherence to the mediterranean diet and risk of frailty and pre-frailty in elderly adults: a systematic review and dose-response meta-analysis with GRADE assessment. Ageing Res Rev, 2023, 87: 101903.
46.	Jalili C, Talebi S, Bagheri R, et al. The association between dietary inflammatory index and aging biomarkers/conditions: a systematic review and dose-response meta-analysis. J Nutr Health Aging, 2023, 27(5): 378-390.
47.	Apóstolo J, Cooke R, Bobrowicz-Campos E, et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review. JBI Database System Rev Implement Rep, 2018, 16(1): 140-232.
48.	Ng TP, Feng L, Nyunt MS, et al. Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: a randomized controlled trial. Am J Med, 2015, 128(11): 1225-1236. e1.
49.	Kim H, Suzuki T, Kim M, et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial. PLoS One, 2015, 10(2): e0116256.
50.	Li X, Zhang Y, Tian Y, et al. Exercise interventions for older people with cognitive frailty - a scoping review. BMC Geriatr, 2022, 22(1): 721.
51.	陈管洁, 张海林, 尹丽霞, 等. 透析中运动对维持性血液透析认知衰弱患者的影响. 护理学杂志, 2022, 37(20): 33-37.
52.	Zhang Y, Zhou JJ, Zhang XM, et al. Management of cognitive frailty: a network meta-analysis of randomized controlled trials. Int J Geriatr Psychiatry, 2023, 38(9): e5994.
53.	梁倩, 汪晓丽, 刘梦琪, 等. 多组分运动护理干预在老年慢性心力衰竭合并衰弱患者中的应用. 中华护理杂志, 2023, 58(23): 2821-2828.
54.	Phoemsapthawee J, Ammawat W, Prasertsri P, et al. Does Gotu kola supplementation improve cognitive function, inflammation, and oxidative stress more than multicomponent exercise alone? - A randomized controlled study. J Exerc Rehabil, 2022, 18(5): 330-342.
55.	李阿敏, 周立恒. 运动-认知双重任务锻炼在血液透析合并认知衰弱病人中的应用. 护理研究, 2024, 38(6): 1064-1067.
56.	Caldo-Silva A, Furtado GE, Chupel MU, et al. Effect of a 40-weeks multicomponent exercise program and branched chain amino acids supplementation on functional fitness and mental health in frail older persons. Exp Gerontol, 2021, 155: 111592.
57.	曹敏, 李琴, 冯莉, 等. 维持性血液透析患者健康素养与衰弱间的链式中介作用. 中华全科医学, 2023, 21(3): 429-433.

1. Beard JR, Officer A, de Carvalho IA, et al. The world report on ageing and health: a policy framework for healthy ageing. Lancet, 2016, 387(10033): 2145-2154.
2. Wang L, Xu X, Zhang M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance. JAMA Intern Med, 2023, 183(4): 298-310.
3. Engels N, de Graav GN, van der Nat P, et al. Shared decision-making in advanced kidney disease: a scoping review. BMJ Open, 2022, 12(9): e055248.
4. 王晗, 王莎莎, 胡树菁, 等. 慢性肾病病人衰弱与不良结局关系的系统综述. 护理研究, 2020, 34(9): 1497-1505.
5. 蒋婷婷, 单岩, 杜理平, 等. 老年血液透析患者认知衰弱现状及其与跌倒恐惧的相关性研究. 中国护理管理, 2020, 20(7): 1005-1009.
6. 陈管洁, 张海林, 尹丽霞, 等. 维持性血液透析患者认知功能障碍与衰弱的相关性. 护理学杂志, 2021, 36(6): 27-31.
7. Panza F, D’Introno A, Colacicco AM, et al. Cognitive frailty: predementia syndrome and vascular risk factors. Neurobiol Aging, 2006, 27(7): 933-940.
8. Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging, 2013, 17(9): 726-734.
9. Woods AJ, Cohen RA, Pahor M. Cognitive frailty: frontiers and challenges. J Nutr Health Aging, 2013, 17(9): 741-743.
10. Dartigues JF, Amieva H. Cognitive frailty: rational and definition from an (Ia.N.a./i.a.g.g.) international consensus group. J Nutr Health Aging, 2014, 18(1): 95.
11. Ruan Q, Xiao F, Gong K, et al. Prevalence of cognitive frailty phenotypes and associated factors in a community-dwelling elderly population. J Nutr Health Aging, 2020, 24(2): 172-180.
12. Mantovani E, Zucchella C, Schena F, et al. Towards a redefinition of cognitive frailty. J Alzheimers Dis, 2020, 76(3): 831-843.
13. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001, 56(3): M146-M156.
14. Abellan van Kan G, Rolland YM, Morley JE, et al. Frailty: toward a clinical definition. J Am Med Dir Assoc, 2008, 9(2): 71-72.
15. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J, 2001, 8(1): 323-336.
16. Gobbens RJ, van Assen MA, Luijkx KG, et al. The tilburg frailty indicator: psychometric properties. J Am Med Dir Assoc, 2010, 11(5): 344-355.
17. Kim M, Jeong MJ, Yoo J, et al. Calf circumference as a screening tool for cognitive frailty in community-dwelling older adults: the Korean frailty and aging cohort study (KFACS). J Clin Med, 2018, 7(10): 332.
18. Montero-Odasso MM, Barnes B, Speechley M, et al. Disentangling cognitive-frailty: results from the gait and brain study. J Gerontol A Biol Sci Med Sci, 2016, 71(11): 1476-1482.
19. Blumen HM, Allali G, Beauchet O, et al. A gray matter volume covariance network associated with the motoric cognitive risk syndrome: a multicohort MRI study. J Gerontol A Biol Sci Med Sci, 2019, 74(6): 884-889.
20. Folstein MF, Folstein SE, Mchugh PR. “MiniMental State”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975, 12(3): 189-198.
21. Nasreddine ZS, Phillips NA, Bédirian V, et al. The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 2005, 53(4): 695-699.
22. Hughes CP, Berg L, Danziger WL, et al. A new clinical scale for the staging of dementia. Br J Psychiatry, 1982, 140(2): 566-572.
23. Jeong JW, Kim KW, Lee DY, et al. A normative study of the revised hasegawa dementia scale: comparison of demographic influences between the revised hasegawa dementia scale and the mini-Mental status examination. Dement Geriatr Cogn Disord, 2007, 24(4): 288-293.
24. Zalavadiya DD, Banerjee A, Sheth AM, et al. A comparative study of depression and associated risk factors among elderly inmates of old age homes and community of rajkot: a Gujarati version of the geriatric depression scale-short form (GDS-G). Indian J Community Med, 2017, 42(4): 204-208.
25. Qiu Y, Li G, Wang X, et al. Prevalence of cognitive frailty among community-dwelling older adults: a systematic review and meta-analysis. Int J Nurs Stud, 2022, 125: 104112.
26. 陈管洁, 张海林, 尹丽霞, 等. 维持性血液透析患者认知衰弱的现状及影响因素分析. 中国护理管理, 2021, 21(8): 1179-1185.
27. McAdams-DeMarco MA, Tan J, Salter ML, et al. Frailty and cognitive function in incident hemodialysis patients. Clin J Am Soc Nephrol, 2015, 10(12): 2181-2189.
28. 勾阳阳, 彭敏. 老年糖尿病病人认知衰弱研究进展. 护理研究, 2024, 38(4): 676-682.
29. Brigola AG, Alexandre TDS, Inouye K, et al. Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults. Dement Neuropsychol, 2019, 13(2): 216-224.
30. 叶丽钦, 张海林, 周莹. 血液透析患者衰弱的相关研究进展. 中华护理杂志, 2018, 53(1): 99-104.
31. 刘春爱, 葛慧, 刘亚萍. 南京市维持性血液透析患者认知衰弱现状及其影响因素调查分析. 华南预防医学, 2023, 49(11): 1417-1420.
32. Schietzel S, Kressig RW, Huynh-Do U. Screening of cognitive performance in kidney transplant recipients: a mini review. Front Nephrol, 2023, 3: 1238501.
33. Seliger SL, Gillen DL, Longstreth WT, et al. Elevated risk of stroke among patients with end-stage renal disease. Kidney Int, 2003, 64(2): 603-609.
34. Findlay MD, Thomson PC, Fulton RL, et al. Risk factors of ischemic stroke and subsequent outcome in patients receiving hemodialysis. Stroke, 2015, 46(9): 2477-2481.
35. Sarnak MJ, Tighiouart H, Scott TM, et al. Frequency of and risk factors for poor cognitive performance in hemodialysis patients. Neurology, 2013, 80(5): 471-480.
36. Tamura MK, Pajewski NM, Bryan RN, et al. Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults. Neurology, 2016, 86(13): 1208-1216.
37. Nortley R, Korte N, Izquierdo P, et al. Amyloid β oligomers constrict human capillaries in Alzheimer’s disease via signaling to pericytes. Science, 2019, 365(6450): eaav9518.
38. Findlay MD, Dawson J, Dickie DA, et al. Investigating the relationship between cerebral blood flow and cognitive function in hemodialysis patients. J Am Soc Nephrol, 2019, 30(1): 147-158.
39. Wolfgram DF. Intradialytic cerebral hypoperfusion as mechanism for cognitive impairment in patients on hemodialysis. J Am Soc Nephrol, 2019, 30(11): 2052-2058.
40. 罗宝林. 老年慢性肾脏病患者认知衰弱现状及风险预测模型的构建. 广东汕头: 汕头大学, 2022.
41. Giang LM, Weiner DE, Agganis BT, et al. Cognitive function and dialysis adequacy: no clear relationship. Am J Nephrol, 2011, 33(1): 33-38.
42. 蒋建新, 茹江丽, 焦宏宇, 等. 慢性肾衰竭病人血液透析后发生认知障碍的预测模型构建与验证. 护理研究, 2023, 37(21): 3838-3844.
43. Meng Y, Wu HT, Niu JL, et al. Prevalence of depression and anxiety and their predictors among patients undergoing maintenance hemodialysis in northern China: a cross-sectional study. Ren Fail, 2022, 44(1): 933-944.
44. 易子涵, 邹兆华, 程新杰, 等. 维持性血液透析患者认知衰弱的现状及影响因素分析. 中国血液净化, 2024, 23(4): 273-277.
45. Poursalehi D, Lotfi K, Saneei P. Adherence to the mediterranean diet and risk of frailty and pre-frailty in elderly adults: a systematic review and dose-response meta-analysis with GRADE assessment. Ageing Res Rev, 2023, 87: 101903.
46. Jalili C, Talebi S, Bagheri R, et al. The association between dietary inflammatory index and aging biomarkers/conditions: a systematic review and dose-response meta-analysis. J Nutr Health Aging, 2023, 27(5): 378-390.
47. Apóstolo J, Cooke R, Bobrowicz-Campos E, et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review. JBI Database System Rev Implement Rep, 2018, 16(1): 140-232.
48. Ng TP, Feng L, Nyunt MS, et al. Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: a randomized controlled trial. Am J Med, 2015, 128(11): 1225-1236. e1.
49. Kim H, Suzuki T, Kim M, et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial. PLoS One, 2015, 10(2): e0116256.
50. Li X, Zhang Y, Tian Y, et al. Exercise interventions for older people with cognitive frailty - a scoping review. BMC Geriatr, 2022, 22(1): 721.
51. 陈管洁, 张海林, 尹丽霞, 等. 透析中运动对维持性血液透析认知衰弱患者的影响. 护理学杂志, 2022, 37(20): 33-37.
52. Zhang Y, Zhou JJ, Zhang XM, et al. Management of cognitive frailty: a network meta-analysis of randomized controlled trials. Int J Geriatr Psychiatry, 2023, 38(9): e5994.
53. 梁倩, 汪晓丽, 刘梦琪, 等. 多组分运动护理干预在老年慢性心力衰竭合并衰弱患者中的应用. 中华护理杂志, 2023, 58(23): 2821-2828.
54. Phoemsapthawee J, Ammawat W, Prasertsri P, et al. Does Gotu kola supplementation improve cognitive function, inflammation, and oxidative stress more than multicomponent exercise alone? - A randomized controlled study. J Exerc Rehabil, 2022, 18(5): 330-342.
55. 李阿敏, 周立恒. 运动-认知双重任务锻炼在血液透析合并认知衰弱病人中的应用. 护理研究, 2024, 38(6): 1064-1067.
56. Caldo-Silva A, Furtado GE, Chupel MU, et al. Effect of a 40-weeks multicomponent exercise program and branched chain amino acids supplementation on functional fitness and mental health in frail older persons. Exp Gerontol, 2021, 155: 111592.
57. 曹敏, 李琴, 冯莉, 等. 维持性血液透析患者健康素养与衰弱间的链式中介作用. 中华全科医学, 2023, 21(3): 429-433.

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Research on the cognitive frailty in maintenance hemodialysis patients

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