title: Mini Mental State Examination over time in chronic hemodialysis patients.
abstract: OBJECTIVE
  Cognitive impairment is relatively common in end-stage renal disease patients on chronic hemodialysis, but the course of cognitive function deterioration in hemodialysis patients is essentially unknown. The present study aimed to evaluate if changes in Mini Mental State Examination (MMSE) over time in hemodialysis (HDP) and elderly (EP) patients differ significantly and determine the variables associated with such possible changes.
  
  
  METHODS
  In 80 HDP and 160 EP, the MMSE was assessed at baseline and after 1 year. Patients were stratified at baseline and at 1 year into three groups according to the MMSE: normal cognitive function >23; mild-moderate cognitive dysfunction: 18-23; severe cognitive dysfunction: <18. Univariate and multivariate analyses were performed to determine the variables associated with MMSE change over time
  
  
  RESULTS
  One-year median reduction of MMSE was greater in HDP (from 24 to 21) than in EP (from 26 to 25) (P<.0001). A higher percentage of HDP than EP switched from normal to mild-moderate or severe MMSE group (P<.0001). At baseline, MMSE was negatively correlated with hypertension (P=.013), angina (P=.007) and Beck Depression Inventory (P=.041) and positively correlated with education (P=.017) and male gender (P=.015). No factors were found to be significantly associated with change of MMSE between baseline and month 12 in HDP.
  
  
  CONCLUSIONS
  One-year MMSE reduction was greater in HDP that in EP. No factors were associated with MMSE reduction in HDP. However, it remains likely that cardiovascular comorbidities and low haemoglobin levels are related to such decline.
authors.affiliation: Hemodialysis Service, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy. maubosso@tin.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bossola
authors.forename: Manuela
authors.initials: M
authors.lastname: Antocicco
authors.forename: Enrico
authors.initials: E
authors.lastname: Di Stasio
authors.forename: Claudia
authors.initials: C
authors.lastname: Ciciarelli
authors.forename: Giovanna
authors.initials: G
authors.lastname: Luciani
authors.forename: Luigi
authors.initials: L
authors.lastname: Tazza
authors.forename: Fausto
authors.initials: F
authors.lastname: Rosa
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000523:psychology* / Q000628:therapy; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D006435:Renal Dialysis / Q000523:psychology*