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. 2023 Feb 4;15(4):813.
doi: 10.3390/nu15040813.

Association between Cognitive Impairment and Malnutrition in Hemodialysis Patients: Two Sides of the Same Coin

Silverio Rotondi  1   2 , Lida Tartaglione  2   3 , Marzia Pasquali  3 , Maria Josè Ceravolo  4 , Anna Paola Mitterhofer  4   5 , Annalisa Noce  4   5 , Monica Tavilla  1 , Silvia Lai  2 , Francesca Tinti  2   3 , Maria Luisa Muci  6 , Alessio Farcomeni  7 , Sandro Mazzaferro  1   2
Affiliations

Association between Cognitive Impairment and Malnutrition in Hemodialysis Patients: Two Sides of the Same Coin

Silverio Rotondi et al. Nutrients. .

Abstract

Cognitive impairment and malnutrition are prevalent in patients on hemodialysis (HD), and they negatively affect the outcomes of HD patients. Evidence suggests that cognitive impairment and malnutrition may be associated, but clinical studies to assess this association in HD patients are lacking. The aim of this study was to evaluate the association between cognitive impairment evaluated by the Montreal Cognitive Assessment (MoCA) score and nutritional status evaluated by the malnutrition inflammation score (MIS) in HD patients. We enrolled 84 HD patients (44 males and 40 females; age: 75.8 years (63.5-82.7); HD vintage: 46.0 months (22.1-66.9)). The MISs identified 34 patients (40%) as malnourished; the MoCa scores identified 67 patients (80%) with mild cognitive impairment (MCI). Malnourished patients had a higher prevalence of MCI compared to well-nourished patients (85% vs. 70%; p = 0.014). MoCa score and MIS were negatively correlated (rho:-0.317; p < 0.01). Our data showed a high prevalence of MCI and malnutrition in HD patients. Low MoCA scores characterized patients with high MISs, and malnutrition was a risk factor for MCI. In conclusion, it is plausible that MCI and malnutrition are linked by common sociodemographic, clinical, and biochemical risk factors rather than by a pathophysiological mechanism.

Keywords: MIS; MoCa; hemodialysis; mild cognitive impairment; protein energy wasting.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of domain-specific deficits in HD patients.
Figure 2
Figure 2
Prevalence of MCI in malnourished and well-nourished patients. Malnourished patients showed a higher percentage of MCI (85%) compared to well-nourished patients (70%). (*) 85% vs. 70%; p = 0.014.
Figure 3
Figure 3
Correlation test between MIS and MoCA score. Spearman’s correlation was used to assess the monotonic covariation of measurements.
See this image and copyright information in PMC

References

    1. Lipnicki D.M., Crawford J., Kochan N.A., Trollor J.N., Draper B., Reppermund S., Maston K., Mather K.A., Brodaty H., Sachdev P.S., et al. Risk factors for mild cognitive impairment, dementia and mortality: The Sydney Memory and Ageing Study. J. Am. Med. Dir. Assoc. 2017;18:388–395. doi: 10.1016/j.jamda.2016.10.014. - DOI - PubMed
    1. Yaffe K., Ackerson L., Tamura M.K., Manjula K.T., Kusek J.W., Sehgal A.R., Cohen D., Anderson C., Appel L., DeSalvo K., et al. Chronic Kidney Disease and Cognitive Function in Older Adults: Findings from the Chronic Renal Insufficiency Cohort Cognitive Study. J. Am. Geriatr. Soc. 2010;58:338–345. doi: 10.1111/j.1532-5415.2009.02670.x. - DOI - PMC - PubMed
    1. Sarnak M.J., Tighiouart H., Scott T.M., Lou K.V., Sorensen E.P., Giang L.M., Drew D.A., Shaffi K., Strom J.A., Singh A.K., et al. Frequency of and risk factors for poor cognitive performance in hemodialysis patients. Neurology. 2013;80:471–480. doi: 10.1212/WNL.0b013e31827f0f7f. - DOI - PMC - PubMed
    1. van Zwieten A., Wong G., Ruospo M., Palmer S.C., Barulli M.R., Iurillo A., Saglimbene V., Natale P., Gargano L., Murgo M., et al. Prevalence and patterns of cognitive impairment in adult hemodialysis patients: The COG-NITIVE-HD study. Nephrol. Dial. Transpl. 2018;33:1197–1206. doi: 10.1093/ndt/gfx314. - DOI - PubMed
    1. Liabeuf S., Pepin M., Franssen C.F., Viggiano D., Carriazo S., Gansevoort R.T., Gesualdo L., Hafez G., Malyszko J., Mayer C., et al. Chronic kidney disease and neurological disorders: Are uraemic toxins the missing piece of the puzzle? Nephrol. Dial. Transpl. 2021;37:ii33–ii44. doi: 10.1093/ndt/gfab223. - DOI - PMC - PubMed