Photo Credit: Mohammed Haneefa Nizamudeen
The following is a summary of “Frailty, but not cognitive impairment, improves mortality risk prediction among those with chronic kidney disease—a nationally representative study,” published in the May 2024 issue of Nephrology by Hong et al.
Older adults with chronic kidney disease (CKD) face higher mortality risks, but typical risk factors don’t predict this well.
Researchers conducted a retrospective study exploring if common geriatric issues like frailty, cognitive impairment, and both together could better predict mortality risk in patients with CKD.
They studied participants aged 60+ from the National Health and Nutrition Examination Survey (2011-2014). The linear regression model was used to look at the links between frailty (physical frailty phenotype) and cognitive function (immediate-recall [CERAD-WL], delayed-recall [CERAD-DL], verbal fluency [AF], executive function/processing speed [DSST], and global), then checked if these links varied by CKD status. Finally, they used Cox models to see if frailty and cognitive impairment (1.5SD below the mean) better-predicted mortality in patients with CKD.
The results showed that among 3,211 participants, 1.4% were cognitively impaired, and 10.0% were frail. Frailty and cognitive impairment were more common in those with CKD (1.2% vs. 0.1%). Frailty was linked to worse global cognitive function (Cohen’s d= -0.26 SD, 95% CI; -0.36 to -0.17) and worse cognitive function across all domains; these associations did not differ by CKD status (Pinteraction >0.05). Mortality prediction improved in patients with CKD considering frailty (P[likelihood ratio test] < 0.001), but not cognitive impairment.
Investigators concluded that frailty, not cognitive impairment, is linked to worse cognitive function and better predicts mortality in patients with CKD, suggesting adding frailty into risk prediction tools to enhance mortality predictions for those with CKD.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03613-y
