INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #16 Neuropsychological Pattern of Performance in Veterans with Kidney Dysfunction Ana Cueli, University of Kentucky, Lexington, United States Shereen Haj-Hassan, Tennessee Valley Healthcare System VA, Nashville, United States Maria Cottingham, Tennesee Valley Healthcare System VA, Nashville, United States Category: Medical/Neurological Disorders/Other (Adult) Keyword 1: neuropsychological assessment Keyword 2: executive functions Keyword 3: memory complaints Objective: To identify patterns of cognition that better help identify kidney dysfunction as a possible etiology for neurocognitive impairment and to inform neuropsychologists’ diagnostic impressions and treatment recommendations. Participants and Methods: Data was collected retrospectively for Veterans who completed routine neuropsychological evaluation at TVHS. Partial correlation analyses were conducted to assess the relationship between eGFR level and scores on different cognitive tasks assessing attention, language, visuospatial ability, executive functioning, verbal and nonverbal memory, processing speed, and motor speed. Age, sex, education, diagnosis, hypertension, hyperlipidemia, CAD, stroke, and diabetes mellitus were controlled for. A total of 189 participants (Veterans over the age of 65) were included in the study (Age M=72, SD=6; Education M=13, SD=2.9; 96% male). Results: There was a positive relationship between eGFR value and WMS LM2 [r(110)=0.20, p<0.5] and Rey-O Copy [r(111)=0.22, p<0.1]. Conclusions: While the relationships found in this study are weaker than expected given previous research, it further supports a relationship between verbal memory and some aspects of executive function, specifically organization and planning. This may suggest that some assessments are more useful in identifying cognitive dysfunction in the setting of kidney disease (as compared to other conditions). Furthermore, identifying the role of kidney dysfunction in cognitive functioning can lead to early identification of kidney disease, early medical intervention, identification of potential reversible etiology for cognitive dysfunction, and improved differential diagnosis. This study has several limitations given that it was a retrospective study which may be addressed in future research. These include limited sample size with limited inclusion of diverse populations as well as limited number of comorbid psychiatric and medical conditions. Additionally, eGFR values were obtained from closest labs obtained and not concurrently with neuropsychological testing. Lastly, some of the cognitive scores available were standard scores while others were raw scores. In addition to addressing these limitations, future research in this area may benefit from analyzing the groups by CKD stage to obtain more granularity of cognitive performance across the stages. Additional lab values that could potentially account for cognitive changes such as hematocrit and TSH may also be considered. Moreover, if sample size allows, the use of more advanced statistical procedures may further assess pattern of scores across cases, which may be helpful identifying more specific patterns. Lastly, given previous research linking polypharmacy to cognitive changes and the increased number of medications taken by older adults, it may be important to consider the number and type of medications taken by participants in future studies.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #16

Neuropsychological Pattern of Performance in Veterans with Kidney Dysfunction

Ana Cueli, University of Kentucky, Lexington, United States
Shereen Haj-Hassan, Tennessee Valley Healthcare System VA, Nashville, United States
Maria Cottingham, Tennesee Valley Healthcare System VA, Nashville, United States

Category: Medical/Neurological Disorders/Other (Adult)

Keyword 1: neuropsychological assessment
Keyword 2: executive functions
Keyword 3: memory complaints

Objective:

To identify patterns of cognition that better help identify kidney dysfunction as a possible etiology for neurocognitive impairment and to inform neuropsychologists’ diagnostic impressions and treatment recommendations.

Participants and Methods:

Data was collected retrospectively for Veterans who completed routine neuropsychological evaluation at TVHS. Partial correlation analyses were conducted to assess the relationship between eGFR level and scores on different cognitive tasks assessing attention, language, visuospatial ability, executive functioning, verbal and nonverbal memory, processing speed, and motor speed. Age, sex, education, diagnosis, hypertension, hyperlipidemia, CAD, stroke, and diabetes mellitus were controlled for. A total of 189 participants (Veterans over the age of 65) were included in the study (Age M=72, SD=6; Education M=13, SD=2.9; 96% male).

Results:

There was a positive relationship between eGFR value and WMS LM2 [r(110)=0.20, p<0.5] and Rey-O Copy [r(111)=0.22, p<0.1].

Conclusions:

While the relationships found in this study are weaker than expected given previous research, it further supports a relationship between verbal memory and some aspects of executive function, specifically organization and planning. This may suggest that some assessments are more useful in identifying cognitive dysfunction in the setting of kidney disease (as compared to other conditions). Furthermore, identifying the role of kidney dysfunction in cognitive functioning can lead to early identification of kidney disease, early medical intervention, identification of potential reversible etiology for cognitive dysfunction, and improved differential diagnosis. This study has several limitations given that it was a retrospective study which may be addressed in future research. These include limited sample size with limited inclusion of diverse populations as well as limited number of comorbid psychiatric and medical conditions. Additionally, eGFR values were obtained from closest labs obtained and not concurrently with neuropsychological testing. Lastly, some of the cognitive scores available were standard scores while others were raw scores. In addition to addressing these limitations, future research in this area may benefit from analyzing the groups by CKD stage to obtain more granularity of cognitive performance across the stages. Additional lab values that could potentially account for cognitive changes such as hematocrit and TSH may also be considered. Moreover, if sample size allows, the use of more advanced statistical procedures may further assess pattern of scores across cases, which may be helpful identifying more specific patterns. Lastly, given previous research linking polypharmacy to cognitive changes and the increased number of medications taken by older adults, it may be important to consider the number and type of medications taken by participants in future studies.