title: Longer dialysis times are associated with a lower chance of dementia among chronic hemodialysis patients.
abstract: Dementia is common in chronic hemodialysis (HD) patients and is associated with a higher mortality. Factors associated with dementia in HD patients are not clear. We investigated factors associated with early dementia in HD patients. Chronic HD patients of 27 hemodialysis centers were enrolled in 2013. Early dementia was identified using the AD8 assessment. Factors associated with early dementia were analyzed using logistic regression. A total of 1617 chronic HD patients including 820 males and 797 females, aged 63.3 ± 13 years, dialyzed for 4 (1.8-8.4) years were analyzed. Early dementia was identified in 414 (25.6%) of the patients. Longer HD times were associated with a lower chance of dementia (P = 0.032), with an adjusted odds ratio (OR) of 0.522 (95% confidence interval [CI]: 0.270-0.969) for every one more hour of HD. Patient's age (OR: 1.587, 95% CI: 1.406-1.791, P < 0.001), body mass index (OR: 0.958, 95% CI: 0.921-0.996, P = 0.031), cerebrovascular accident (OR: 1.480, 95% CI: 1.000-2.188), diabetes (OR: 1.894, 95% CI: 1.390-2.581, P < 0.001), and serum albumin (OR: 0.376, 95 % CI: 0.256-0.553, P < 0.001) were independently linked to early dementia. Short hemodialysis times are associated with early dementia in a chronic hemodialysis population with a quarter of patients having early dementia. Patients' age, nutrition status and comorbidity are independently linked to early dementia.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Tai-Te
authors.initials: TT
authors.lastname: Wu
authors.forename: Chieh-Ying
authors.initials: CY
authors.lastname: Chang
authors.forename: Tzu-Jen
authors.initials: TJ
authors.lastname: Chen
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D003704:Dementia / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
keywords: Chronic kidney disease; Early dementia; Hemodialysis; Nutrition