Cognitive frailty in maintenance hemodialysis: a scoping review

Purpose: To conduct a scoping review of the related research on cognitive frailty (CF) in maintenance hemodialysis (MHD) patients, so as to provide a basis for early diagnosis, treatment and intervention of CF in MHD patients.

Methods: Utilizing a scoping review approach, we searched PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, the China Biological Medicine Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu (VIP) for literature on CF in MHD patients up to October 20, 2024. Two researchers conducted independent screening and data extraction of the literature's fundamental characteristics. The study is registered in OSF ( https://doi.org/10.17605/OSF.IO/H6Q89 ).

Results: The review included 21 articles, revealing a concerningly high prevalence of CF in MHD patients, ranging from 4.6 to 56.4%. Six diagnostic combinations were identified, with the combination of Frailty Phenotype (FP), Montreal Cognitive Assessment (MOCA), and Clinical Dementia Rating (CDR) scales being the most prevalent. Influencing factors were categorized into demographic and lifestyle, physical condition, disease-related and psychosocial aspects. Interventions included exercise, cognitive therapy combined with exercise, social support and predictive nursing, yet there remains a scarcity of intervention studies.

Conclusion: The prevalence of CF in MHD patients is high; however, understanding of CF in MHD patients is insufficient. There are many types of assessment tools, but there is a lack of unified standards and specificity; the influencing factors are complex and diverse; and prevention and intervention studies are scarce.