PREVALENCE OF COGNITIVE IMPAIRMENT, REDUCED GRIP STRENGTH AND MAJOR ADVERSE CARDIOVASCULAR EVENTS IN PATIENTS FROM TWO SATELLITE HAEMODIALYSIS CENTRES IN INNER WESTERN SYDNEY: A PROSPECTIVE COHORT STUDY.
Dr LUCY QIU-YUN WANG1, Dr YOUSEF HAKIMI2, Dr BLAKE ANTHONY HICKEY3, RN NELSON UBERA11, Dr MIRNA VUCAK-DZUMHUR4,5,6,7,8, Professor GRAHAME ELDER4,7,9,10
1Department of Renal Medicine, Nepean Hospital, Kingswood, Australia, 2Monash Medical Centre, Clayton, Australia, 3Department of Anaesthesia, Shoalhaven Hospital, Nowra, Australia, 4Department of Renal Medicine, Westmead Hospital, Westmead, Australia, 5Department of Renal Medicine, Blacktown Hospital, Blacktown, Australia, 6Auburn Hospital, Auburn, Australia, 7University of Notre Dame, Chippendale, Australia, 8University of Western Sydney, Sydney, Australia, 9University of Sydney, Camperdown, Australia, 10Garvan Institute of Medical Research, Darlinghurst, Australia, 11Auburn Community Dialysis Centre, Auburn Hospital, Auburn, Australia
Background: Cognitive impairment (CI) is common in individuals with kidney failure on haemodialysis (HD). CI has also been associated with ageing, frailty and all-cause mortality.
Aim: To quantify the burden of CI in two Inner Western Sydney satellite HD centres using the Montreal Cognitive Assessment (MoCA), and to determine the impact of CI on risks for major adverse cardiovascular events (MACE) and mortality.
Methods: In this prospective cohort study, data was collected via questionnaire and linkage to the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA). Screening for CI was performed using the MoCA and grip strength (GS) was assessed using a handheld dynamometer.
Results: Our sample of 64 participants had a mean (SD) age of 60.8 (14.9) years, and 56.3% were male. CI was present in 78.1–89.1% of the population (using MoCA cut-off scores of 26 and 24, respectively) and the mean (SD) MoCA score was 19.8 (5.5). Over 80% of participants had visuospatial and language deficits, while 95.3% had impaired delayed recall. Greater age (standardised beta coefficient -.409; p=.002 [95% CI -.245, -.061]) and lower body mass index (BMI) (standardised beta coefficient -.301; p=.018 [95% CI -.039, -.405]) were significantly associated with lower overall MOCA scores. GS was reduced in 72.9% of the overall population, 80.6% of men and 60.7% of women. Association between mortality and age was of borderline significance (p=.052). CI at baseline did not predict MACE or all-cause mortality.
Conclusion: A large proportion of the Inner Western Sydney HD patients had CI and reduced GS. CI was significantly associated with age and lower BMI. MACE was associated with older age but not with other factors included in the analyses.
Biography:
Dr Lucy Wang is a nephrologist at Nepean Hospital. Her special interests include obstetric medicine, hypertensive disorders of pregnancy, diabetes-related kidney disease and dialysis. Dr Wang completed her nephrology training at Westmead, Nepean and Blacktown Hospitals and was awarded her Fellowship of the Royal Australasian College of Physicians (FRACP) in 2024. She is actively involved in teaching with the University of Sydney Nepean Clinical School. She has published research in peer-reviewed journals and is currently undertaking research on glomerular disorders in pregnancy. She is a member of ANZSN, SOMANZ and ISSHP.