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Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study

BACKGROUND: Chronic kidney disease (CKD) is prevalent in older adults. In the aging CKD population, cognitive frailty is more common, but its prevalence and associated risk factors need to be further investigated. METHODS: This is a cross-sectional study that enrolled patients aged ≥ 60 years with a...

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Autores principales: Chang, Jing, Hou, Wenwen, Li, Yanchun, Li, Shujuan, Zhao, Kai, Wang, Yanfei, Hou, Yuanping, Sun, Qianmei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386941/
https://www.ncbi.nlm.nih.gov/pubmed/35978304
http://dx.doi.org/10.1186/s12877-022-03366-z
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author Chang, Jing
Hou, Wenwen
Li, Yanchun
Li, Shujuan
Zhao, Kai
Wang, Yanfei
Hou, Yuanping
Sun, Qianmei
author_facet Chang, Jing
Hou, Wenwen
Li, Yanchun
Li, Shujuan
Zhao, Kai
Wang, Yanfei
Hou, Yuanping
Sun, Qianmei
author_sort Chang, Jing
collection PubMed
description BACKGROUND: Chronic kidney disease (CKD) is prevalent in older adults. In the aging CKD population, cognitive frailty is more common, but its prevalence and associated risk factors need to be further investigated. METHODS: This is a cross-sectional study that enrolled patients aged ≥ 60 years with a diagnosis of CKD from January 2018 to February 2021. Patients were assessed for frailty and cognition with the FRAIL and the Mini-Mental State Examination (MMSE) scales and were divided into the cognitive frailty and non-cognitive frailty groups. Risk factors for cognitive frailty were identified by univariate and multivariate logistic regression analyses. A prediction model for cognitive frailty was built and a nomogram was plotted. The performance of the nomogram was evaluated by using a concordance index (C-index) and calibration plots. RESULTS: A total of 1015 older patients with CKD were enrolled, among whom 607 (59.8%) were males and 408 (40.2%) were females, with an age ranging from 60 to 98 years, and an cognitive frailty prevalence of 15.2%. The prevalence of cognitive frailty varied among the CKD stages 1–5, with rates of 4.7%, 7.5%, 13.8%, 18.5%, and 21.4%, respectively. Multivariate logistic regression analysis showed that age (OR = 1.11, 95%CI 1.08–1.14, p < 0.001), depression (OR = 2.52, 95%CI 1.54–4.11, p < 0.001), low social support (OR = 2.08, 95%CI 1.28–3.39, p = 0.003), Charlson comorbidity index (CCI) (OR = 1.92, 95%CI 1.70–2.18, p < 0.001), eGFR (OR = 0.98, 95%CI 0.96–0.99, p < 0.001) and albuminuria (OR = 5.93, 95%CI 3.28–10.74, p < 0.001) were independent risk factors affecting the association with cognitive frailty in older patients with CKD. A nomogram for assessing cognitive frailty was established and well-calibrated with a C-index of 0.91 (95%CI 0.89–0.94). CONCLUSIONS: The prevalence of cognitive frailty was higher in older patients having CKD. Advanced age, comorbidity, depression, low social support, eGFR and albuminuria were independent risk factors for CKD accompanied with cognitive frailty.
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spelling pubmed-93869412022-08-19 Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study Chang, Jing Hou, Wenwen Li, Yanchun Li, Shujuan Zhao, Kai Wang, Yanfei Hou, Yuanping Sun, Qianmei BMC Geriatr Research BACKGROUND: Chronic kidney disease (CKD) is prevalent in older adults. In the aging CKD population, cognitive frailty is more common, but its prevalence and associated risk factors need to be further investigated. METHODS: This is a cross-sectional study that enrolled patients aged ≥ 60 years with a diagnosis of CKD from January 2018 to February 2021. Patients were assessed for frailty and cognition with the FRAIL and the Mini-Mental State Examination (MMSE) scales and were divided into the cognitive frailty and non-cognitive frailty groups. Risk factors for cognitive frailty were identified by univariate and multivariate logistic regression analyses. A prediction model for cognitive frailty was built and a nomogram was plotted. The performance of the nomogram was evaluated by using a concordance index (C-index) and calibration plots. RESULTS: A total of 1015 older patients with CKD were enrolled, among whom 607 (59.8%) were males and 408 (40.2%) were females, with an age ranging from 60 to 98 years, and an cognitive frailty prevalence of 15.2%. The prevalence of cognitive frailty varied among the CKD stages 1–5, with rates of 4.7%, 7.5%, 13.8%, 18.5%, and 21.4%, respectively. Multivariate logistic regression analysis showed that age (OR = 1.11, 95%CI 1.08–1.14, p < 0.001), depression (OR = 2.52, 95%CI 1.54–4.11, p < 0.001), low social support (OR = 2.08, 95%CI 1.28–3.39, p = 0.003), Charlson comorbidity index (CCI) (OR = 1.92, 95%CI 1.70–2.18, p < 0.001), eGFR (OR = 0.98, 95%CI 0.96–0.99, p < 0.001) and albuminuria (OR = 5.93, 95%CI 3.28–10.74, p < 0.001) were independent risk factors affecting the association with cognitive frailty in older patients with CKD. A nomogram for assessing cognitive frailty was established and well-calibrated with a C-index of 0.91 (95%CI 0.89–0.94). CONCLUSIONS: The prevalence of cognitive frailty was higher in older patients having CKD. Advanced age, comorbidity, depression, low social support, eGFR and albuminuria were independent risk factors for CKD accompanied with cognitive frailty. BioMed Central 2022-08-17 /pmc/articles/PMC9386941/ /pubmed/35978304 http://dx.doi.org/10.1186/s12877-022-03366-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Chang, Jing
Hou, Wenwen
Li, Yanchun
Li, Shujuan
Zhao, Kai
Wang, Yanfei
Hou, Yuanping
Sun, Qianmei
Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study
title Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study
title_full Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study
title_fullStr Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study
title_full_unstemmed Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study
title_short Prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study
title_sort prevalence and associated factors of cognitive frailty in older patients with chronic kidney disease: a cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9386941/
https://www.ncbi.nlm.nih.gov/pubmed/35978304
http://dx.doi.org/10.1186/s12877-022-03366-z
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