title: Depression and Cognitive Impairment in Peritoneal Dialysis: A Multicenter Cross-sectional Study.
abstract: BACKGROUND
  Depression and cognitive impairment have been identified as independent risk factors for mortality in peritoneal dialysis (PD) patients. The relationship between depression and global and specific cognitive functions in PD patients was investigated in this study.
  
  
  METHODS
  Multicenter cross-sectional study.
  
  
  METHODS
  458 clinically stable patients, drawn from 5 PD units, who performed PD for at least 3 months were enrolled.
  
  
  METHODS
  Depression, defined as depression severity index score > 0.5 using the Zung Self-rating Depression Scale.
  
  
  RESULTS
  Global and specific cognitive impairment. Global cognitive function was measured using the Modified Mini-Mental State Examination (3MS), Trail-Making Test forms A and B for executive function, and subtests of the Battery for the Assessment of Neuropsychological Status for immediate and delayed memory, visuospatial skills, and language ability.
  
  
  RESULTS
  Prevalences of depression and cognitive impairment evaluated by the 3MS were 52% and 28.4%, respectively. Patients with mild or moderate/severe depression had higher prevalences of general cognitive impairment, executive dysfunction, and impaired immediate and delayed memory. After adjusting for demographics, comorbid conditions, and clinical parameters, depression scores were independently associated with lower 3MS scores, lower immediate and delayed memory and language ability scores, and longer completion times of Trails A and B. Even mild depression was independently associated with higher risk for cognitive impairment, executive dysfunction, and impaired immediate and delayed memory after multivariable adjustments.
  
  
  CONCLUSIONS
  The causal relationship between depression and cognitive impairment could not be determined, and the potential copathogenesis behind depression and cognitive impairment was not fully investigated.
  
  
  CONCLUSIONS
  Even mild depression is closely associated with global and specific cognitive impairment in PD patients.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Institute of Nephrology, Peking University, Beijing, China; Key Laboratory of Renal Disease, Ministry of Health, Beijing, China; Key Laboratory of Renal Disease, Ministry of Education, Beijing, China. Electronic address: dongjie@medmail.com.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Dong
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China; Institute of Nephrology, Peking University, Beijing, China; Key Laboratory of Renal Disease, Ministry of Health, Beijing, China; Key Laboratory of Renal Disease, Ministry of Education, Beijing, China.
authors.forename: Hai-Chen
authors.initials: HC
authors.lastname: Pi
authors.affiliation: Renal Division, Peking University Shenzhen Hospital, Shenzhen, China.
authors.forename: Zu-Ying
authors.initials: ZY
authors.lastname: Xiong
authors.affiliation: Renal Division, Peking University Shenzhen Hospital, Shenzhen, China.
authors.forename: Jin-Lan
authors.initials: JL
authors.lastname: Liao
authors.affiliation: Renal Division, the Second Hospital of Anhui Medical University, Anhui, China.
authors.forename: Li
authors.initials: L
authors.lastname: Hao
authors.affiliation: Renal Division, the Second Hospital of Anhui Medical University, Anhui, China.
authors.forename: Gui-Ling
authors.initials: GL
authors.lastname: Liu
authors.affiliation: Renal Division, the Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China.
authors.forename: Ye-Ping
authors.initials: YP
authors.lastname: Ren
authors.affiliation: Renal Division, Handan Central Hospital, Hebei, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Renal Division, Handan Central Hospital, Hebei, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Duan
authors.affiliation: Renal Division, Handan Central Hospital, Hebei, China.
authors.forename: Zhao-Xia
authors.initials: ZX
authors.lastname: Zheng
mesh_terms: D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence
keywords: Peritoneal dialysis (PD); chronic kidney disease (CKD); cognitive dysfunction; cognitive impairment; depression; end-stage renal disease (ESRD); executive dysfunction; executive impairment