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Article Abstract
Objectives: Cognitive impairment is common in haemodialysis patients and is associated with increased hospitalization and mortality. However, subjective cognitive complaints (SCCs), the self-experienced difficulties in everyday cognitive activities, remain poorly understood. This study examined the prevalence and course of SCCs in haemodialysis patients and its longitudinal associations with sociodemographic, clinical and patient-reported variables.
Design: Observational prospective study with baseline and 12-month follow-up assessment.
Methods: Based on a validated cut-off point on the Kidney Disease Quality of Life Cognitive Function subscale, haemodialysis patients (N = 159; 40.3% female, mean age 53.62) were classified into cognitive complaint trajectories: (1) resilient (60.4%; no/low SCCs throughout); (2) persistent (8.8%; stable high SCCs); (3) deterioration (17.6%; from no/low to high SCCs); and (4) recovery (13.2%; from high to no/low SCCs). Sociodemographic/clinical characteristics, self-efficacy, self-management skills, adherence, mood and biochemical assays were measured at both assessments and compared among trajectories using mixed ANOVAs.
Results: Interaction effects indicated significant improvements in the recovery group in clinical outcomes (i.e., decreased phosphorus and calcium-phosphorus product), self-efficacy and mood over time. Group effects indicated significantly poorer self-efficacy, self-management skills and adherence in the persistent group than other trajectories across both assessments. None of the sociodemographic/clinical characteristics was associated with SCC trajectories.
Conclusions: The extent of SCCs vary over time across haemodialysis patients. Routine screening of SCCs in dialysis settings may help identifying patients at risk of poor self-management and worse prognosis. Strategies that compensate for cognitive lapses may mitigate the perceived cognitive burden of this population.
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| http://dx.doi.org/10.1111/bjhp.12645 | DOI Listing |
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