Abstract: FR-PO927
Accelerated Brain Aging in ESRD Patients
Session Information
- Geriatric Nephrology
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Geriatric Nephrology
- 901 Geriatric Nephrology
Authors
- Chuang, Yi-Fang, Far Eastern Memorial Hospital, Taipei, Taiwan
- Shu, Kai-Hsiang, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
- Peng, Yu-sen, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
- Chiu, Yen-Ling, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan
Background
Patients with end-stage renal disease (ESRD) suffer from higher risk of cognition impairment and dementia compared to the general population. It is known that brain structure changes appear years before the development of cognitive impairments and dementia. However, the relationship between brain structure changes and cognitive functions in ESRD patients has never been studied.
Methods
Twenty-six patients on maintenance hemodialysis without dementia and fifty-two age-matched non-renal failure control individuals were recruited from the Far Eastern Memorial Hospital (For ESRD patients, average age: 59.9 years and 31% had diabetes). All patients lives an independent life and can attend hemodialysis treatment independently. Brain structure was measured by 3T-MRI and analyzed using Freesurfer. A battery of neuropsychological tests were also performed.
Results
Mini Mental State Examination (MMSE) scores were comparable between ESRD patients and control subjects (28.5 vs 28.6). However, ESRD patients showed poorer performance in psychomoter speed and executive function, measured by symbol search, sympbol substitution, trail making task and Stroop test after adjusting for age, gender, diabetes and education level (all P <0.05). Neverthelss, there was no difference in both immediate recall or delayed recall memory tests. In addition, ESRD patients showed decreased volume in total gray matter and numerous brain structures, especially decreased volume of hippocampus (-0.98 mm3), amygdala (-0.34 mm3), and putamen (-1.61mm3, all P <0.001).
Conclusion
As the overall ESRD population grow older, how to prevent cognitive function decline and dementia is a pressing issue. Our study indicates that ESRD patients exhibit numerous accelerated brain aging represented by decreased brain volume in specific areas pertinent to the development of mild cogntive impairment (MCI) and dementia. Whether these changes are predicitive of further cognitive decline requires further study.
Funding
- Government Support - Non-U.S.