title: Cognitive impairment in elderly renal inpatients: an under-identified phenomenon.
abstract: OBJECTIVE
  Cognitive impairment is a common but under-recognised problem in patients with chronic kidney disease, and is likely to become more significant as this patient population ages.
  
  
  METHODS
  This cross-sectional study focussed on inpatients aged ≥65 years at a tertiary renal unit, and consisted of two parts. Part 1 (n = 25) considered whether cognitively impaired inpatients were being identified and being referred to memory services. In Part 2 (n = 105) two different cognitive function tests were attempted (6-CIT, MMSE).
  
  
  RESULTS
  In Part 1, cognitive function tests were attempted in only 4 patients at admission and 1 patient subsequently. No patients were referred to memory services. In Part 2, 6-CIT was abnormal (score ≥8) in 61.4%, and MMSE was abnormal (score <27) in 79.5% (score 21-26: 28.9%, 15-20: 28.9%, 10-14: 13.3%, <10: 8.4%). There was a close correlation between MMSE and 6-CIT (R(2) = 0.735). Only 7.2% of those assessed had a documented cognitive deficit prior to admission.
  
  
  CONCLUSIONS
  This is the first study looking at cognition in elderly inpatients with chronic kidney disease. There appears to be a much higher rate of cognitive impairment than expected and this is largely unidentified. These deficits are likely to have a major impact on both inpatient and outpatient management.
authors.affiliation: Imperial Renal and Transplant Centre, Hammersmith Hospital, London, UK.
authors.forename: Gargi
authors.initials: G
authors.lastname: Banerjee
authors.forename: Shreya
authors.initials: S
authors.lastname: Karia
authors.forename: James
authors.initials: J
authors.lastname: Varley
authors.forename: Edwina A
authors.initials: EA
authors.lastname: Brown
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015995:Prevalence; D012017:Referral and Consultation; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000523:psychology* / Q000628:therapy