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ORIGINAL RESEARCH article

Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 16 - 2024 | doi: 10.3389/fnagi.2024.1457675
This article is part of the Research Topic Mental, Sensory, Physical and Life Style Parameters Related to Cognitive Decline in Aging View all 9 articles

Association between cerebral blood flow variation and cognitive decline in elderly patients undergoing hemodialysis

Provisionally accepted
Yidan Guo Yidan Guo 1Wei Cui Wei Cui 1Pengpeng Ye Pengpeng Ye 2Yang Luo Yang Luo 1*
  • 1 Beijing Shijitan Hospital, Capital Medical University, Beijing, China
  • 2 Chinese Center For Disease Control and Prevention, Beijing, China

The final, formatted version of the article will be published soon.

    The mechanism of cognitive impairment in hemodialysis patients is multifactorial.The relationship between cerebral blood flow and the decline of cognitive function is poorly understood.Objective: To investigate the association between cerebral blood flow variation and decline of cognitive function in elderly patients undergoing hemodialysis.: In this prospective observational cohort study of 121 elderly patients undergoing hemodialysis, we used transcranial Doppler ultrasound (TCD) to measure cerebral arterial mean flow velocity (MFV) throughout dialysis, assessed cognitive function at baseline and 12-month follow-up, and then analyzed associations between MFV and changes on cognitive scores. Results: TCD recordings demonstrated a significant reduction in MFV throughout dialysis, which were significantly correlated with cumulative ultrafiltration volume (rho 0.356, P<0.001), ΔSBP (rho 0.251, P=0.005), and ΔMAP (rho 0.194, P=0.032). Compared with the baseline assessments, cognitive scores of participants at the 12-month follow-up were significantly worsened in global cognition (MOCA), some tests of memory (CFT-memory), executive function (TMT-B, SCWT-C, and SCWT-T), attention/processing speed (SDMT), and visuospatial function (CFT-copy) (P<0.05). The worsening scores in global cognition (MOCA) (β=0.066, 95% CI 0.018-0.113, P=0.007) and some tests of memory (AVLT5) (β=0.050, 95% CI 0.004-0.097, P=0.035) and executive function (TMT-B， SCWT-C, SCWT-T) (β=1.955, 95% CI 0.457-3.453, P=0.011; β=0.298, 95% CI 0.112-0.484, P=0.002 and β=1.371, 95% CI 0.429-2.303, P=0.004, respectively) were significantly associated with the reduction of MFV. Conclusions: Hemodialysis may significantly reduce cerebral blood flow in elderly patients; Repetitive intradialytic decreases in CBF may be one of the mechanisms underlying the decline of cognitive function.

    Keywords: hemodialysis, cognitive decline, cerebral arterial mean flow velocity (MFV), Transcranial doppler ultrasound (TCD), neurocognitive battery

    Received: 01 Jul 2024; Accepted: 04 Sep 2024.

    Copyright: © 2024 Guo, Cui, Ye and Luo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yang Luo, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

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