ABSTRACT
BACKGROUND: Hemodialysis patients are at high risk for cognitive impairment due to their older age and high prevalence of stroke and cardiovascular risk factors. METHODS: Using a cross-sectional design, the authors measured cognitive function in 374 hemodialysis patients aged 55 years and older and an age-matched comparison group in Minneapolis and St. Paul, MN. Cognitive performance was measured in three domains: memory, executive function, and language. Subjects were classified as having no, mild, moderate, or severe cognitive impairment. RESULTS: Of 338 subjects who completed testing in at least two of the three cognitive domains, 13.9% (95% CI 10.4, 18.1) were classified with mild impairment, 36.1% (31.0, 41.5) with moderate impairment, 37.3% (32.1, 42.7) with severe impairment, and 12.7% (9.4, 16.8) with normal cognition. Only 2.9% had a documented history of cognitive impairment. Factors associated with severe cognitive impairment on adjusted logistic regression were stroke (adjusted OR [AOR] 1.95; 95% CI 1.08, 3.49; p < 0.03), equilibrated Kt/V > 1.2 (1.67; 1.01, 2.75; p < 0.05), and education >12 years (0.32; 0.14, 0.72; p < 0.01). The AOR for severe cognitive impairment in a random sample of 101 hemodialysis patients vs an age-matched comparison group was 3.54 (1.28, 9.78; p < 0.02). CONCLUSIONS: Moderate to severe cognitive impairment is common and undiagnosed in hemodialysis patients. Further studies are needed to determine whether dialysis exacerbates the cognitive impairment attributable to underlying disease. Cognitive testing in hemodialysis patients before dialysis initiation and periodically may be warranted.
Subject(s)
Cognition Disorders/epidemiology , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/rehabilitation , Renal Dialysis/statistics & numerical data , Risk Assessment/methods , Age Distribution , Aged , Aged, 80 and over , Cohort Studies , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Minnesota/epidemiology , Prevalence , Risk Factors , Sex DistributionSubject(s)
Achievement , Aptitude , Defense Mechanisms , Intelligence , Adult , Anxiety Disorders/psychology , Humans , MaleABSTRACT
The validity of the Short Portable Mental Status Questionnaire (SPMSQ) was evaluated using two criteria: clinical diagnosis and neuropsychological diagnosis. The 40 study participants represented a mixed clinical sample of neurologic and psychiatric patients, all of whom were or had been inpatients. Laboratory data (CT, EEG, etc.) were available for 45% of the patients. Neuropsychological diagnosis of organic impairment was based on an extensive test battery. The SPMSQ did not significantly relate to either clinical or neuropsychological diagnosis. It is recommended that a "normal" score on the SPMSQ be regarded as nonspecific regarding organic cognitive impairment rather than suggestive of normal brain functioning.
Subject(s)
Diagnostic Errors , Mental Disorders/diagnosis , Mental Status Schedule , Neurocognitive Disorders/diagnosis , Psychiatric Status Rating Scales , Aged , Cognition , Female , Humans , Male , Mental Processes , Middle Aged , Neurocognitive Disorders/psychology , Neuropsychological TestsABSTRACT
Administered the Multivariate Personality Inventory (MPI) and established measures of psychopathy to students (N = 71) to determine the relationship between the Character Disorder Style subscale of the MPI and psychopathy. Results clearly showed the independence of the Character Disorder Style subscale and psychopathy. Additionally, the Manic Style subscale was shown to be independent from both psychopathy and the Character Disorder Style subscale.
Subject(s)
Antisocial Personality Disorder/psychology , Personality Inventory , Adult , Humans , MMPI , Male , Personality Disorders/psychology , PsychometricsABSTRACT
Reports the continued development of a multivariate theory of personality styles and a scale, the Multivariate Personality Inventory, designed to measure these styles in both pathological and normal populations. In a sample of college women, theory-generated predictions of the manifest needs of each personality style were examined with the Edwards Personal Preference Schedule. Results supported the validity of the Multivariate Personality Inventory in regard to the need profile of each personality style group. To examine the relationship between the personality styles and behavior, a series of time estimation measures also were employed.
