Cognitive Impairment in CKD: Pathophysiology, Management, and Prevention

Publication date: Available online 1 August 2019Source: American Journal of Kidney DiseasesAuthor(s): David A. Drew, Daniel E. Weiner, Mark J. SarnakPatients with chronic kidney disease (CKD) are at substantially higher risk for developing cognitive impairment compared with the general population, and both lower glomerular filtration rate and the presence of albuminuria are associated with the development of cognitive impairment and poorer cognitive function. Given the excess of vascular disease seen in individuals with CKD, cerebrovascular disease is likely the predominant pathology underlying these associations, though impaired clearance of uremic metabolites, depression, sleep disturbance, anemia, and polypharmacy may also contribute. Modification of vascular disease risk factors may be helpful in limiting decline, though definite data are lacking. Specific to CKD, targeting a low blood pressure and reduction in albuminuria with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may slow cognitive decline, albeit modestly. Initiation of dialysis can improve severe impairment associated with uremia but does not appear to affect more subtle chronic cognitive impairment. In contrast, kidney transplantation appears to lead to improved cognitive function in many transplant recipients, suggesting that dialysis methods do not provide the same cognitive benefits as having a functioning kidney. Management of patients with both CKD and cognitive impairment sho...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research

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Source: Social Work in Health Care - Category: International Medicine & Public Health Authors: Source Type: research
Publication date: Available online 24 January 2020Source: Preventive MedicineAuthor(s): Terrence D. Hill, Benjamin Dowd-Arrow, Amy M. Burdette, Lauren HaleAbstractAlthough there is no empirical evidence linking gun ownership with better sleep, speculation is widespread in gun culture. We assess the direct association between gun ownership and sleep disturbance and whether gun ownership moderates the association between neighborhood fear and sleep disturbance. We use four waves of cross-sectional data from the General Social Survey (2010–2018) and logistic regression to model sleep disturbance as a function of gun own...
Source: Preventive Medicine - Category: International Medicine & Public Health Source Type: research
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Source: Journal of Sports Sciences - Category: Sports Medicine Authors: Source Type: research
Publication date: Available online 24 January 2020Source: International Journal of PsychophysiologyAuthor(s): Peter E. Clayson, Kaylie A. Carbine, Michael J. LarsonAbstractPerformance-monitoring event-related brain potentials (ERPs), such as the error-related negativity (ERN) and reward positivity (RewP), are advocated as biomarkers of depression symptoms and risk. However, a recent meta-analysis indicated effect size heterogeneity in the ERN and RewP literatures. Hence, advocating these ERPs as biomarkers of depression might be premature or possibly misguided due to the selective reporting of significant analyses on the p...
Source: International Journal of Psychophysiology - Category: Psychiatry & Psychology Source Type: research
Abstract Life review (LR) therapy has received considerable support as an effective treatment for depression among older adults. Researchers believe that providing LR does not require extensive training and can be done by family members who are not psychiatric professionals. If so, then training family caregivers to provide LR is a potential strategy for alleviating the shortage of resources for treating depression among the growing population of older adults experiencing depression. A pilot study that explored the feasibility of that strategy had mixed results. Seventeen (89%) of 19 caregiver-care recipient dyads...
Source: Journal of Gerontological Nursing - Category: Nursing Authors: Tags: J Gerontol Nurs Source Type: research
Publication date: Available online 25 January 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Jiadela Teliewubai, Ximin Fan, Hongwei Ji, Rusitanmujiang Maimaitiaili, Jiamin Tang, Song Zhao, Shikai Yu, Chen Chi, Yawei Xu, Yi ZhangAbstractBackground and AimsMetabolic unhealthiness and obesity are both associated with an increased risk of cardiovascular disease. We aimed to investigate the significance of metabolic unhealthiness and obesity in organ damages in a community-based elderly cohort.Methods and results3325 elderly participants (>65 years old) were recruited in northern Shanghai. Associatio...
Source: Nutrition, Metabolism and Cardiovascular Diseases - Category: Nutrition Source Type: research
Conclusion: The SBP at 7:00 AM, in addition to the 24-hour mSBP, is also associated with eGFR deterioration in patients with diabetic CKD, particularly in those with CKD stage 3-5. PMID: 31969922 [PubMed]
Source: Electrolyte and Blood Pressure - Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research
Publication date: Available online 24 January 2020Source: Multiple Sclerosis and Related DisordersAuthor(s): Asiye Tuba Ozdogar, Ozge Ertekin, Turhan Kahraman, Pinar Yigit, Serkan OzakbasBackground: Developments in rehabilitation technology such as video-based exergaming contributes to the treatment process as well as to increase the active participation of persons with multiple sclerosis (pwMS). The aim was to investigate the effect of video-based exergaming training on upper extremity and cognitive function as well as core stability, walking, depression, fatigue, and quality of life in pwMS.Methods: This randomized contr...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
Publication date: March 2020Source: Epilepsy &Behavior, Volume 104, Part AAuthor(s): Diana Paardekooper, Zoe Thayer, Laurie Miller, Armin Nikpour, Michael B GascoigneAbstractSleep difficulties are commonly reported by patients with epilepsy and can have a detrimental impact on overall quality of life. The purpose of this pilot study was to assess the efficacy of a psychotherapeutic approach, namely Cognitive Behavioral Therapy for Insomnia (CBT-I), in improving sleep quality in patients with epilepsy. Twenty outpatients with epilepsy who reported poor sleep quality were randomized to either a control or CBT-I treatment...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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