title: Association between dialysis treatment and cognitive decline: A study from the Project in Sado for Total Health (PROST), Japan.
abstract: OBJECTIVE
  Evidence for the association between dialysis treatment and cognitive decline is limited. The present study aimed to determine whether dialysis treatment is associated with cognitive decline in adult outpatients of a general hospital in Japan.
  
  
  METHODS
  This was a cross-sectional substudy of the Project in Sado for Total Health (PROST). Total Health PROST targeted adult outpatients of a general hospital in Sado City, Niigata, Japan. Among 753 patients (mean age 68.1 ± 11.6 years) analyzed, 66 received dialysis. Cognitive state was evaluated using the Mini-Mental State Examination, and those with a Mini-Mental State Examination score <24 were considered "cognitively declined." The prevalence of cognitive decline was compared by odds ratios calculated with multiple logistic regression analysis. Variables included in the analyses were dialysis, age, sex and self-reported histories of hypertension, diabetes, stroke and ischemic heart disease.
  
  
  RESULTS
  Of the 66 dialysis patients, 24 (36.4%) showed cognitive decline, whereas 172 (25.0%) of 687 non-dialysis patients showed cognitive decline. The age and sex-adjusted odds ratio for cognitive decline in dialysis patients was 2.57 (95% confidence interval 1.43-4.61), relative to non-dialysis patients. The odds ratio remained significant (odds ratio 2.69, 95% confidence interval 1.49-4.88) even after adjusting for all covariates.
  
  
  CONCLUSIONS
  The prevalence of cognitive decline was high in dialysis patients relative to non-dialysis patients among outpatients of a general hospital in Japan. Geriatr Gerontol Int 2017; 17: 1584-1587.
authors.affiliation: Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Yumi
authors.identifier: http://orcid.org/0000-0002-9046-3249
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: JA Niigata Koseiren Sado General Hospital, Niigata, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sanpei
authors.affiliation: Center for Inter-organ Communication Research, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Minako
authors.initials: M
authors.lastname: Wakasugi
authors.affiliation: Department of Molecular Neuroscience, Resource Branch for Brain Disease Research, Brain Research Institute, Niigata University, Niigata, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Yokoseki
authors.affiliation: Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Kabasawa
authors.affiliation: Department of Molecular Neuroscience, Resource Branch for Brain Disease Research, Brain Research Institute, Niigata University, Niigata, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Onodera
authors.affiliation: Department of Molecular Genetics, Brain Research Institute, University of Niigata, Niigata, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ikeuchi
authors.affiliation: Department of Molecular Genetics, Brain Research Institute, University of Niigata, Niigata, Japan.
authors.forename: Ryozo
authors.initials: R
authors.lastname: Kuwano
authors.affiliation: JA Niigata Koseiren Sado General Hospital, Niigata, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Momotsu
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.affiliation: Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Endo
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000523:psychology* / Q000628:therapy*
keywords: Japan; cognitive impairments; cross-sectional studies; end-stage kidney disease; renal dialysis