Cognitive impairment and depression in a population of patients with chronic kidney disease in Colombia: a prevalence study
Rodríguez-Angarita, Carlos Edgardo | 2016-05-10
Background: Growth of the elderly population is linked to the increase of comorbid conditions such as chronic
kidney disease (CKD), depression, and cognitive impairment (CI). Cognitive impairment can vary from minimal
deficits in the normal aging, to mild cognitive impairment with a prevalence ranging from 1 to 29 % in people ≥ 65 years
of age, up to severe impairment with a prevalence of 6 to 42 %. The CI induced by depression usually affects the
functional performance of the elderly.
Objective: The objective of the study is to describe the prevalence of CI and depression in patients ≥ 55 years
with CKD stages 3 and 4, attending a secondary prevention program during 2012–2013.
Design: The design of the study is a cross-sectional study of simple random sampling, and 308 patients were
invited to participate.
Setting: Patients were being treated in a CKD secondary prevention program in Bogotá, Colombia, during 2012–2013.
Patients: Participants were over 54 years diagnosed with CKD in stages 3 to 4 according to the K/DOQI classification.
Measurements: CI was assessed using NEUROPSI and modified Lawton Scale; depression was measured with
Yesavage Geriatric Depression Scale and the MINI International Neuropsychiatric Interview.
Methods: Through an interview with the subjects, information regarding age, occupation, civil status, educational
level, and clinical baseline variables was collected. Clinical assessment with specific instruments was performed by
a multidisciplinary team composed of nephrologists, a psychiatrist, a neurologist, and a neuropsychologist.
Results: Two hundred and fifty-one patients agreed to participate. The average age was 76.3 (SD = 7.9) years,
67 % were males, and 86.5 % had CKD stage 3. Overall prevalence of CI was 51 % (95 % CI 44.7 to 57.2), and the
prevalence of major depression reached 8 % (95 % CI 4.5 to 11.3); 4.8 % of the patients (n = 12) had both CI and
Limitations: A limitation of the study is its design, which does not allow establishing the direction of the association
between predictors and outcomes. Suggested associations must be interpreted cautiously as they are generated
as hypothesis, which should be investigated in properly designed trials.
Conclusions: CI and depression are prevalent conditions among patients with CKD stages 3–4, with the greatest
occurrence of CI, affecting half of the investigated Colombian patients with age ≥ 55 years.