Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: a cross-sectional study.

Abstract

Background: Subjective cognitive decline (SCD) significantly increases a patient's risk of long-term cognitive decline and is common in adults. However, few studies have evaluated patients with end-stage renal disease receiving maintenance hemodialysis (MHD). In addition, the relationship between frailty and SCD in MHD patients remains unclear. Therefore, this study aimed to assess the potential factors affecting SCD in MHD patients and to investigate the relationship between frailty and SCD.

Methods: This was a cross-sectional study. From December 2023 to April 2024, via the convenience sampling method, a total of 171 patients from West China Hospital of Sichuan University were recruited to participate in this study. The demographic and sociological characteristics of the participants were assessed via a general information questionnaire. The subjective cognitive decline questionnaire 9 (SCD-Q9), the Tilburg frailty indicator (TFI), the subjective global nutritional assessment (SGA) and the grip dynamometer were used to assess the participants' subjective cognitive level, frailty, nutritional status, and grip strength, respectively. Univariate analyses were used to examine potential factors associated with SCD. Linear regression was used to analyze the relationships between these factors and SCD. Spearman's correlation was used to assess the association between SCD and frailty.

Results: The average subjective cognitive decline score of the 171 MHD patients was 4.00 (2.00-7.00), and 95 patients (55.56%) with scores > 3 presented with SCD. Linear regression analysis revealed that sex, work status, grip strength, SGA, and frailty were influential factors in MHD patients, explaining 38.80% of the total variation in SCD. Spearman's analysis revealed that SCD was positively correlated with frailty in MHD patients (r = 0.431, P < 0.001).

Conclusions: The prevalence of SCD in MHD patients is common and correlates with certain patient characteristics, including sex, work status, grip strength, SGA, and frailty. Healthcare workers should pay attention to the assessment of subjective cognitive function in this population, remain aware of the risk factors for SCD, and take targeted interventions as early as possible, which can help improve the quality of survival and slow the occurrence of cognitive impairment.