Olczyk Piotr, Jerzak Patryk, Letachowicz Krzysztof, Gołębiowski Tomasz, Krajewska Magdalena, Kusztal Mariusz
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland.
J Clin Med. 2023 Mar 4;12(5):2042. doi: 10.3390/jcm12052042.
(1) Background: Cognitive impairment (CI) is more prevalent in hemodialysis (HD) patients than in the general population. The purpose of this study was to examine if behavioral, clinical, and vascular variables are linked with CI in individuals with HD. (2) Methods: Initially, 47 individuals with chronic HD volunteered to participate in the trial, but only 27 patients ultimately completed the Montreal Cognitive Assessment (MoCA) and the Computerized Cognitive Assessment Tool (CompBased-CAT). We collected information on smoking, mental activities, physical activity (Rapid Assessment of Physical Activity, RAPA), and comorbidity. The oxygen saturation (rSO2) and pulse wave velocity (PWV; IEM Mobil-O-Graph) of the frontal lobes were measured. (3) Results: Significant associations were discovered between MoCA and rSO2 (r = 0.44, p = 0.02 and r = 0.62, = 0.001, right/left, respectively), PWV (r = -0.69, = 0.0001), CCI (r = 0.59, = 0.001), and RAPA (r = 0.72, = 0.0001). Those who actively occupied their time during dialysis and non-smokers achieved higher cognitive exam results. A multivariate regression study demonstrated that physical activity (RAPA) and PWV had separate effects on cognitive performance. (4) Conclusions: Cognitive skills are related to inter-dialysis healthy habits (physical activity, smoking) and intra-dialysis activities (tasks and mind games). Arterial stiffness, oxygenation of the frontal lobes, and CCI were linked with CI.
(1) 背景：认知障碍（CI）在血液透析（HD）患者中比在普通人群中更为普遍。本研究的目的是检验行为、临床和血管变量是否与HD个体的CI相关。(2) 方法：最初，47名慢性HD患者自愿参加试验，但最终只有27名患者完成了蒙特利尔认知评估（MoCA）和计算机化认知评估工具（CompBased-CAT）。我们收集了吸烟、精神活动、身体活动（身体活动快速评估，RAPA）和合并症的信息。测量了额叶的氧饱和度（rSO2）和脉搏波速度（PWV；IEM Mobil-O-Graph）。(3) 结果：发现MoCA与rSO2（r = 0.44，p = 0.02和r = 0.62，p = 0.001，分别为右侧/左侧）、PWV（r = -0.69，p = 0.0001）、CCI（r = 0.59，p = 0.001）和RAPA（r = 0.72，p = 0.0001）之间存在显著关联。在透析期间积极安排时间的人和不吸烟者在认知测试中取得了更高的成绩。多变量回归研究表明，身体活动（RAPA）和PWV对认知表现有独立影响。(4) 结论：认知技能与透析间期的健康习惯（身体活动、吸烟）和透析期活动（任务和智力游戏）有关。动脉僵硬度、额叶氧合和CCI与CI相关。
