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接受血液透析的慢性肾脏病患者的认知衰弱及其危险因素:一项横断面研究

Cognitive Frailty and Its Risk Factors Among Patients With Chronic Kidney Disease Receiving Hemodialysis: A Cross-Sectional Study.

作者信息

Ho Mu-Hsing, Chen Pei-Chi, Liu Megan F, Lee Jung Jae

机构信息

School of Nursing, LKS Faculty of Medicine, The University Hong Kong, Pokfulam, Hong Kong.

Hemodialysis Center, Cardinal-Tien Hospital, New Taipei City, Taiwan.

出版信息

Nurs Health Sci. 2025 Sep;27(3):e70197. doi: 10.1111/nhs.70197.

Abstract

Cognitive frailty can lead to an impaired functional capacity and a poor quality of life, especially in patients on hemodialysis. This study aimed to investigate cognitive frailty and its risk factors in patients with chronic kidney disease (CKD) receiving hemodialysis. A cross-sectional study was conducted between April and June 2021 involving 220 patients with CKD receiving hemodialysis at a hospital-based hemodialysis center in northern Taiwan. Data were collected using a structured survey covering demographics, cognitive function, physical frailty, depressive symptoms, physical activity, and nutritional status. Univariate and multivariate logistic regression models were used to identify risk factors for cognitive frailty. In total, 220 patients were recruited. Prevalences of cognitive impairment, physical frailty, depressive symptoms, and cognitive frailty were 46.8%, 10.0%, 52.3%, and 9%, respectively. Univariate and multivariate logistic regression analyses, adjusted for age, sex, and years of hemodialysis, identified malnutrition (aOR = 12.405; 95% CI = 3.29-46.81) and physical inactivity (aOR = 89.445; 95% CI = 5.87-1363.93) as significant risk factors for cognitive frailty. The study suggests the need for strategies to enhance physical activity and nutritional status to prevent cognitive frailty in patients with CKD receiving hemodialysis.

摘要

认知衰弱会导致功能能力受损和生活质量下降,尤其是在接受血液透析的患者中。本研究旨在调查接受血液透析的慢性肾脏病(CKD)患者的认知衰弱及其危险因素。2021年4月至6月进行了一项横断面研究,纳入了台湾北部一家医院血液透析中心的220例接受血液透析的CKD患者。通过结构化调查收集数据,内容涵盖人口统计学、认知功能、身体衰弱、抑郁症状、身体活动和营养状况。采用单因素和多因素逻辑回归模型来确定认知衰弱的危险因素。共招募了220例患者。认知障碍、身体衰弱、抑郁症状和认知衰弱的患病率分别为46.8%、10.0%、52.3%和9%。在对年龄、性别和血液透析年限进行调整后,单因素和多因素逻辑回归分析确定营养不良(调整后比值比[aOR]=12.405;95%置信区间[CI]=3.29-46.81)和身体活动不足(aOR=89.445;95%CI=5.87-1363.93)是认知衰弱的重要危险因素。该研究表明,需要采取策略来增强身体活动和营养状况,以预防接受血液透析的CKD患者出现认知衰弱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b48/12284913/5027150d1165/NHS-27-e70197-g001.jpg

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