Relationship between physical performance and mild cognitive impairment in elderly hemodialysis patients is modified by the presence of diabetes: A multicenter cross-sectional study

Yinjiao Zhao; Peiyu Song; Chan Zhu; Lingyun Zhang; Xiaoyu Chen; Hui Zhang; Peipei Han; Wei Ding; Jianying Niu; Junli Zhao; Xiang Shao; Liming Zhang; Chen Yu; Jia Xu; Chenghu Fang; Qi Guo

doi:10.3389/fendo.2022.897728

Relationship between physical performance and mild cognitive impairment in elderly hemodialysis patients is modified by the presence of diabetes: A multicenter cross-sectional study

Front Endocrinol (Lausanne). 2022 Sep 9:13:897728. doi: 10.3389/fendo.2022.897728. eCollection 2022.

Authors

Yinjiao Zhao¹, Peiyu Song¹, Chan Zhu¹, Lingyun Zhang¹, Xiaoyu Chen², Hui Zhang¹, Peipei Han², Wei Ding³, Jianying Niu⁴, Junli Zhao⁵, Xiang Shao⁶, Liming Zhang⁷, Chen Yu⁸, Jia Xu⁹, Chenghu Fang¹, Qi Guo^{1

2}

Affiliations

¹ Jiangwan Hospital of Hongkou District, Shanghai University of Medicine and Health Science Affiliated First Rehabilitation Hospital, Shanghai, China.
² Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China.
³ Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁴ Department of Nephrology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China.
⁵ Department of Nephrology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
⁶ Department of Nephrology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medcine, Suzhou, China.
⁷ Department of Nephrology, Zhabei Central Hospital of Jingan District, Shanghai, China.
⁸ Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
⁹ Department of Nephrology, Shanghai Pudong New Area People's Hospital, Shanghai, China.

Abstract

Objective: The purpose of this study was to observe the relationship between physical performance and mild cognitive impairment (MCI) in the presence or absence of type 2 diabetes in elderly hemodialysis patients.

Methods: In this multicenter cross-sectional study, 396 clinically stable and aged ≥60 years hemodialysis patients (255 men; mean age: 68.3 ± 5.9 years) were included from seven dialysis units in Shanghai, China. The Chinese version of the Modified Mini-Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scale were utilized to assess MCI. The performance-based assessments consisted of three physical tests, grip strength (GS), Timed Up and Go Test (TUGT), and 4-m walking test, which respectively represent muscle strength, mobility, and walking speed (WS). Logistic regression and multivariate linear regression were used for analysis.

Results: Hemodialysis patients with diabetes had a high prevalence of MCI (20.6%). The odds ratio (OR) of MCI for the interacted items [(TUGT) * (diabetes) and (WS) * (diabetes)] was significant (p < 0.05). In diabetes patients, TUGT was positively associated with MCI, and WS was negatively associated with MCI after adjusting covariates [OR = 0.129; 95% confidence interval (CI) = 0.028-0.704, p = 0.021]. However, no significant association was found between physical performance and MCI in the non-diabetes hemodialysis patients (p > 0.05). Further analysis showed that TUGT was negatively associated with attention and calculation and language. WS was positively associated with recall and language in diabetic hemodialysis patients.

Conclusions: Physical performance was associated with MCI in diabetic hemodialysis patients rather than the non-diabetes group. Whether increasing mobility or WS can positively influence MCI in individuals with type 2 diabetes requires further study.

Keywords: diabetes; hemodialysis; mild cognitive impairment; physical performance; walking speed.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged
China / epidemiology
Cognitive Dysfunction* / epidemiology
Cognitive Dysfunction* / etiology
Cross-Sectional Studies
Diabetes Mellitus, Type 2* / complications
Humans
Male
Middle Aged
Physical Functional Performance
Postural Balance
Renal Dialysis
Time and Motion Studies