A cross-sectional assessment of key cognitive domains affected in Chronic dialysis patients with associated co-morbidities: A pilot study

Cognitive impairment is a common but under-recognized complication in patients undergoing dialysis, with limited data available from India. This cross-sectional study assessed the cognitive abilities of 32 patients undergoing chronic dialysis using the Montreal Cognitive Assessment [MoCA]. Methodology A single-center cross-sectional design was used to evaluate 32 adults with CKD stages 3-5. Cognitive function was assessed using the 30-point MoCA tool. Descriptive statistics and non-parametric tests [Mann-Whitney U and Kruskal-Wallis tests] were applied, with significance set at p < 0.05. Ethical approval was obtained from the Institutional Ethics Committee. Results MoCA scores classified 10 patients as normal, 7 with mild impairment, 9 with moderate impairment, and 6 with severe impairment of cognitive function. The most affected domains were delayed recall [1.0 ± 1.3/5], attention [3.8 ± 2.3/6], and abstraction [1.1 ± 0.8/2]. Patients with diabetes showed a trend toward poorer cognitive scores [14.5 ± 7.3] than non-diabetics [19.4 ± 5.8] [p = 0.094]. Individuals with cognitive impairment had significantly lower pulse rates [p = 0.0331] and shorter dialysis durations [p = 0.0329]. Age [r = –0.4122, p = 0.022] and dialysis duration [r = 0.3473, p = 0.051] showed notable associations with MoCA scores, whereas blood pressure, sex, and occupation were not significantly related. Conclusion Most participants demonstrated cognitive impairment, highlighting the importance of routine cognitive screening in long-term dialysis care. Rehabilitation strategies should consider age, dialysis duration, and comorbidities, such as diabetes and hypertension. The findings suggest a link between autonomic function, dialysis adaptation, and cognitive status, underscoring the need for evidence-based cognitive rehabilitation programs to support patients undergoing chronic dialysis.