Patient-reported cognitive functioning and daily functioning in chronic dialysis patients.
Patient-reported cognitive functioning and daily functioning in chronic dialysis patients.
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DOI：
10.1111/hdi.12202
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Gilet CA
中科院分区：
文献类型：
--
作者：
Song MK;Ward SE;Bair E;Weiner LJ;Bridgman JC;Hladik GA;Gilet CA
主观认知障碍对日常功能、与健康相关的生活质量和医疗保健消费产生负面影响，并预示着许多患者群体未来的认知能力下降。然而，尚未对透析患者的多维认知功能的主观测量进行评估。我们的目的是检验(1)患者报告的(主观)认知功能和客观认知功能之间的关系，以及(2)透析患者的主观和客观认知功能与日常功能之间的关系。我们使用了一项正在进行的对透析患者多维生活质量轨迹的纵向观察研究的基线数据。135名患者完成了电话神经心理测试(BTACT，客观认知功能的测量)、主观认知功能(PAOFI)和日常功能测量(ADL和IADL)。在控制了年龄和教育程度后，主观和客观认知功能之间存在适度的相关性(r=0.33p>；0.001)。多因素Logistic回归模型显示，主观而非客观的认知功能是ADLS和IADLS的显著预测因子。这些发现表明认知功能主观测量的潜在临床价值，而不是取代客观测量或诊断性测试，而是优化临床评估和管理的意义。
Subjective cognitive impairment negatively affects daily functioning, health-related quality of life, and healthcare consumption and is predictive of future cognitive decline in many patient populations. However, no subjective measures of multidimensional cognitive functioning have been evaluated for dialysis patients. Our purposes were to examine (1) the association between patient-reported (subjective) cognitive functioning and objective cognitive functioning and (2) the relationships between subjective and objective cognitive functioning and everyday functioning of dialysis patients. We used baseline data from an on-going longitudinal observational study of trajectories in dialysis patients’ multidimensional quality of life. 135 patients completed a telephone-based neuropsychological battery (BTACT, a measure of objective cognitive functioning), a measure of subjective cognitive functioning (PAOFI), and measures of everyday functioning (ADLs and IADLs). After controlling for age and education, there was a modest correlation (r = 0.33, p > 0.001) between subjective and objective cognitive functioning. Multivariate logistic regression models showed subjective, but not objective, cognitive functioning was a significant predictor of both ADLs and IADLs. The findings suggest the potential clinical value of subjective measures of cognitive functioning, not to replace objective measures or diagnostic tests, but rather to optimize the meaningfulness of clinical assessment and management.
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