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A comparison of end-stage renal disease and Alzheimer’s disease in the elderly through a comprehensive geriatric assessment

  • Nephrology - Original Paper
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Abstract

Purpose

The percentage of patients receiving haemodialysis (HD) treatment and of patients with Alzheimer’s disease (AD) within the elderly population is increasing day by day. Functional dependence, malnutrition, cognitive impairment or depression impairs the quality of life and increases mortality in both diseases. This study aims to assess HD and AD patients through comprehensive geriatric assessment (CGA) and compare their results.

Method

A total of 579 patients (121 HD, 188 AD patients and 270 control subjects) over the age of 65, who were followed at geriatric and nephrology departments between January 2011 and July 2012, were included in this prospective cross-sectional study. Mini-Mental State Examination, Mini-Nutritional Assessment, Geriatric Depression Scale and basic and Instrumental Activities of Daily Living indexes were applied to all patients. The results obtained were compared among the patient groups.

Results

The mean age of the participants was 72.6 ± 8.2. Based on the CGA findings, the results for both groups were considerably different from control group. While depression scores were observed higher in HD patients than in AD patients, cognition, nutrition and functional capacity were mostly affected in AD patients.

Conclusion

The management of geriatric HD patients is substantially complex. Depression, cognitive impairment and decrease in functional capacity can often be overlooked, so findings may be ascribed to underlying kidney impairment. Therefore, comprehensive geriatric assessment should be regularly performed in HD patients in order to detect problems at an early stage, to take necessary preventative measures, to initiate treatment as soon as possible and to enhance quality of life.

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References

  1. Bowling CB, Muntner P (2012) Epidemiology of chronic kidney disease among older adults: a focus on the oldest old. J Gerontol A Biol Sci Med Sci 67(12):1379–1386

    PubMed  Google Scholar 

  2. Canaud B, Tong L, Tentori F, Akiba T, Karaboyas A, Gillespie B, Akizawa T, Pisoni RL, Bommer J, Port FK (2011) Clinical practices and outcomes in elderly hemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Clin J Am Soc Nephrol 6(7):1651–1662

    Article  PubMed  Google Scholar 

  3. Süleymanlar G, Utaş C, Arinsoy T, Ateş K, Altun B, Altiparmak MR, Ecder T, Yilmaz ME, Çamsari T, Başçi A, Odabas AR, Serdengeçti K (2011) A population-based survey of chronic REnal disease in Turkey—the CREDIT study. Nephrol Dial Transplant 26:1862–1871

    Article  PubMed Central  PubMed  Google Scholar 

  4. Parker TF (2012) The economic burden of geriatric ESRD. Semin Dial 25(6):664–667

    Article  PubMed  Google Scholar 

  5. Elias MF, Dore GA, Davey A (2013) Kidney disease and cognitive function. Contrib Nephrol 179:42–57

    Article  PubMed  Google Scholar 

  6. Feng L, Yap KB, Yeoh LY, Ng TP (2012) Kidney function and cognitive and functional decline in elderly adults: findings from the Singapore longitudinal aging study. J Am Geriatr Soc 60(7):1208–1214

    Article  PubMed  Google Scholar 

  7. De Giorgi A, Fabbian F, Pala M, Mallozzi Menegatti A, Misurati E, Manfredini R (2012) Falls and renal function: a dangerous association. G Ital Nefrol 29(3):293–300

    PubMed  Google Scholar 

  8. Edalat-Nejad M, Qlich-Khani M (2013) Quality of life and sleep in hemodialysis patients. Saudi J Kidney Dis Transpl 24(3):514–518

    Article  PubMed  Google Scholar 

  9. Wilhelm-Leen ER, Hall YN K, Tamura M, Chertow GM (2009) Frailty and chronic kidney disease: the third national health and nutrition evaluation survey. Am J Med 122(7):664–671

    Article  PubMed Central  PubMed  Google Scholar 

  10. Saeed Z, Ahmad AM, Shakoor A, Ghafoor F, Kanwal S (2012) Depression in patients on hemodialysis and their caregivers. Saudi J Kidney Dis Transpl 23(5):946–952

    Article  PubMed  Google Scholar 

  11. Aucella F, Stoico L, Cicchella A, Gesuete A, Greco A, Grandaliano G, Pilotto A (2012) Comprehensive geriatric assessment in the hemodialysis elderly population. J Nephrol 25(Suppl 19):S85–S89

    Article  PubMed  Google Scholar 

  12. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology 34(7):939–944

    Article  CAS  PubMed  Google Scholar 

  13. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. Text Revision, Washington DC

    Google Scholar 

  14. Isik AT, Bozoglu E, Eker D (2012) AChE and BuChE inhibition by rivastigmin have no effect on peripheral insulin resistance in elderly patients with alzheimer disease. J Nutr Health Aging 16(2):139–141

    Article  CAS  PubMed  Google Scholar 

  15. Gillette-Guyonnet S, Lauque S, Ousset PJ (2005) Nutrition and Alzheimer’s disease. Psychol Neuropsychiatr Vieil 3(Suppl 1):S35–S41

    PubMed  Google Scholar 

  16. Guerin O, Soto ME, Brocker P, Robert PH, Benoit MB, Vellas B, REAL.FR Group (2005) Nutritional status assessment during alzheimer’s disease: results after one year (the REAL French Study Group). J Nutr Health Aging. 9(2):81–84

    CAS  PubMed  Google Scholar 

  17. Kovacs J, Pakaski M, Juhasz A, Feher A, Drotos G, Fazekas CO, Horvath TL, Janka Z, Kalman J (2012) Acetylcholinesterase (AChE) inhibition and serum lymphokines in Alzheimer’s disease: friend or foe? Neuropsychopharmacol Hung 14(1):19–27

    PubMed  Google Scholar 

  18. Dukkipati R, Kopple JD (2009) Causes and prevention of protein-energy wasting in chronic kidney failure. Semin Nephrol 29:39–49

    Article  PubMed  Google Scholar 

  19. Post JB, Morin KG, Sano BM, Jegede AB, Langhoff E, Spungen AM (2012) Increased presence of cognitive impairment in hemodialysis patients in the absence of neurological events. Am J Nephrol 35:120–126

    Article  PubMed Central  PubMed  Google Scholar 

  20. Maurizio B, Manuela A, Di Enrico St, Claudia C, Giovanna L, Luigi T, Fausto R, Graziano O (2011) Mini mental state examination over time in chronic hemodialysis patients. J Psychosom Res 71:50–54

    Article  Google Scholar 

  21. Fazekas G, Fazekas F, Schmidt R, Kapeller P, Offenbacher H, Krejs GJ (1995) Brain MRI findings and cognitive impairment in patients undergoing chronic hemodialysis treatment. J Neurol Sci 134(1–2):83–88

    Article  CAS  PubMed  Google Scholar 

  22. Agganis BT, Weiner DE, Giang LM, Scott T, Tighiouart H, Griffith JL, Sarnak MJ (2010) Depression and cognitive function in maintenance hemodialysis patients. Am J Kidney Dis 56(4):704–712

    Article  PubMed Central  PubMed  Google Scholar 

  23. Mok WY, Chu LW, Chung CP, Chan NY, Hui SL (2004) The relationship between non-cognitive symptoms and functional impairment in Alzheimer’s disease. Int J Geriatr Psychiatry 19(11):1040–1046

    Article  CAS  PubMed  Google Scholar 

  24. Opara JA (2012) Activities of daily living and quality of life in alzheimer disease. J Med Life 12 5(2):162–167

    CAS  Google Scholar 

  25. Choi J, Myung W, Chung JW, Kang HS, Na DL, Kim SY, Lee JH, Han SH, Choi SH, Kim S, Kim S, Carroll BJ, Kim DK (2013) Association between functional impairment, depression, and extrapyramidal signs in neuroleptic-free patients with Alzheimer disease. J Geriatr Psychiatry Neurol 26(3):144–150

    Article  PubMed  Google Scholar 

  26. Sood MM, Rigatto C, Bueti J, Jassal V, Miller L, Verrelli M, Bohm C, Mojica J, Roberts D, Komenda P (2011) The role of functional status in discharge to assisted care facilities and in-hospital death among dialysis patients. Am J Kidney Dis 58(5):804–812

    Article  PubMed  Google Scholar 

  27. Farrokhi F, Jassal SV (2013) Routine use of an abbreviated 4-item scale to assess dependence in essential activities of daily living amongst elderly hemodialysis patients: a validation study. Int Urol Nephrol 45(1):259–264

    Article  PubMed  Google Scholar 

  28. Steffens DC, Skoog I, Norton MC, Hart AD, Tschanz JT, Plassman BL, Wyse BW, Welsh-Bohmer KA, Breitner JC (2000) Prevalence of depression and its treatment in an elderly population: the cache county study. Arch Gen Psychiatry 57(6):601–607

    Article  CAS  PubMed  Google Scholar 

  29. Gracia-García P, De-la-Cámara C, Santabárbara J, Lopez-Anton R, Quintanilla MA, Ventura T, Marcos G, Campayo A, Saz P, Lyketsos C,Lobo A (2013) Depression and incident alzheimer disease: the impact of disease severity. Am J Geriatr Psychiatry. 20: S1064-7481(13)00158-9

  30. Nebes RD, Reynolds CF, Boada F, Meltzer CC, Fukui MB, Saxton J, Halligan EM, DeKosky ST (2002) Longitudinal increase in the volume of white matter hyperintensities in late-onset depression. Int J Geriatr Psychiatry 17(6):526–530

    Article  PubMed  Google Scholar 

  31. Boulware LE, Liu Y, Fink NE, Coresh J, Ford DE, Klag MJ, Powe NR (2006) Temporal relation among depression symptoms, cardiovascular disease events, and mortality inend-stage renal disease: contribution of reverse causality. Clin J Am Soc Nephrol 1(3):496–504

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to thank Turkish Kidney Foundation and Bilal Görçin, MD who followed the HD patients. We would like to acknowledge Dr. Hulya Ellidokuz for her help in statistical evaluation of the study. We would also like to thank Dr. Doğan Kaplan and Rana Tekcan for their help in the English translation of the manuscript.

Conflict of interest

The authors declare that they have no conflicting interests. This study did not have a sponsor.

Author information

Authors and Affiliations

  1. Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey

    Pinar Soysal & Ahmet Turan Isik

  2. Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Banu Buyukaydin

  3. Department of Nephrology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Rumeyza Kazancioglu

Authors
  1. Pinar Soysal
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  2. Ahmet Turan Isik
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  3. Banu Buyukaydin
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  4. Rumeyza Kazancioglu
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Correspondence to Pinar Soysal.

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Soysal, P., Isik, A.T., Buyukaydin, B. et al. A comparison of end-stage renal disease and Alzheimer’s disease in the elderly through a comprehensive geriatric assessment. Int Urol Nephrol 46, 1627–1632 (2014). https://doi.org/10.1007/s11255-014-0739-5

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  • DOI: https://doi.org/10.1007/s11255-014-0739-5

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