Subjective Cognitive Decline Affects Over Half of Hemodialysis Patients: Researchers Call for Early Interventions
China: A recent study, published in BMC Nephrology has shed light on the prevalence and associated factors of subjective cognitive decline (SCD) in patients undergoing maintenance hemodialysis (MHD), emphasizing the clinical significance of early assessment and intervention. The cross-sectional study found that more than half of patients receiving MHD experience SCD, with frailty emerging as a key contributing factor.
The researchers identified associations between SCD and employment status, sex, reduced grip strength, poor nutritional status, and frailty, collectively explaining 38.8% of its variance. Conducting early cognitive assessments in MHD patients may help mitigate long-term cognitive deterioration.
Subjective cognitive decline is prevalent among adults and is a known risk factor for long-term cognitive impairment. However, its impact on patients with end-stage renal disease undergoing maintenance hemodialysis remains understudied. The connection between frailty and SCD in this population is also not well understood. To bridge this gap, Huaihong Yuan, West China School of Nursing, Sichuan University, Chengdu, China, and colleagues aimed to identify factors influencing SCD in MHD patients and explore its association with frailty.
For this purpose, the researchers conducted a cross-sectional study from December 2023 to April 2024, recruiting 171 patients from West China Hospital of Sichuan University through convenience sampling. Demographic and sociological characteristics were assessed using a general information questionnaire. Subjective cognitive function, frailty, nutritional status, and grip strength were evaluated using SCD-Q9, TFI, SGA, and a grip dynamometer, respectively. Univariate analyses identified factors linked to SCD, while linear regression examined their relationships. Spearman’s correlation assessed the association between SCD and frailty.
The study led to the following findings:
- The average subjective cognitive decline score among 171 MHD patients was 4.00.
- SCD was present in 95 patients (55.56%) with scores greater than 3.
- Linear regression analysis identified sex, work status, grip strength, nutritional status (SGA), and frailty as key influencing factors, accounting for 38.80% of SCD variation.
- Spearman’s analysis showed a significant positive correlation between SCD and frailty (r = 0.431).
The researchers highlighted that subjective cognitive decline is prevalent in maintenance hemodialysis patients, with sex, employment status, grip strength, nutritional status, and frailty as key contributing factors. Given its impact on long-term cognitive function, early assessment and targeted interventions are crucial.
"While our study offers valuable insights, its single-center, small-sample nature and lack of biochemical analysis limit generalizability. Future multi-center cohort studies with random sampling and expanded biochemical evaluations are needed to better understand the underlying mechanisms and refine intervention strategies for improving cognitive health in MHD patients," the researchers concluded.
Reference:
Li, J., Gao, Y., Li, X. et al. Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: a cross-sectional study. BMC Nephrol 26, 92 (2025). https://doi.org/10.1186/s12882-025-04020-7
