Evidence map›Paper›PMID 26573615›Full record

ArticleClinical journal of the American Society of Nephrology : CJASN2015

Frailty and Cognitive Function in Incident Hemodialysis Patients.

Mara A McAdams-DeMarco, Jingwen Tan, Megan L Salter, Alden Gross, Lucy A Meoni, Bernard G Jaar, Wen-Hong Linda Kao, Rulan S Parekh, Dorry L Segev, Stephen M Sozio

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 126 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
126citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

126 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Association Between Frailty and Cognitive Impairment in Chronic Kidney Disease: A Systematic Review and Meta-Analysis.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026
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  20. Cognitive frailty in maintenance hemodialysis: a scoping review.International urology and nephrology · 2025
    Article

66 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Mara A McAdams-DeMarcoDepartments of Epidemiology and Departments of Surgery and mara@jhu.edu.
Jingwen TanDepartments of Epidemiology and.
Megan L SalterDepartments of Epidemiology and Departments of Surgery and.
Alden GrossDepartments of Epidemiology and.
Lucy A MeoniBiostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;
Bernard G JaarDepartments of Epidemiology and Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Nephrology Center of Maryland, Baltimore, Maryland;
Wen-Hong Linda KaoDepartments of Epidemiology and.
Rulan S ParekhMedicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Divisions of Nephrology, Hospital for Sick Children and University Health Network, Toronto, Canada; and Departments of Pediatrics and Medicine, University of Toronto, Toronto, Canada.
Dorry L SegevDepartments of Epidemiology and Departments of Surgery and.
Stephen M SozioMedicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;

Funding

Technological Assessment and Solutions Core - RC4P30AG021334 · NIA · JOHNS HOPKINS UNIVERSITY · PI Jeremy D Walston · 2003 to 2026
$33.2M
CARDIOVASCULAR EPIDEMIOLOGY INSTITUTIONAL TRAININGT32HL007024 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Elizabeth Selvin · 1985 to 2026
$17.5M
Institute for Clinical and Translational Research (KL2)KL2RR025006 · NCRR · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2007 to 2011
$12.9M
Longitudinal Study of DialysisR01DK072367 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI PAREKH, RULAN S · 2007 to 2011
$3.7M
Frailty and Risk Prediction in Older Adults Considering Kidney Transplantation Supp OlorundareR01AG042504 · NIA · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2013 to 2017
$3.4M
Patient Oriented Research in Kidney Disease and Transplant SurgeryK24DK101828 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2014 to 2018
$922k
Frailty and Adverse Health Outcomes of Aging in Older Adults with Kidney FailureK01AG043501 · NIA · JOHNS HOPKINS UNIVERSITY · PI MCADAMS DEMARCO, MARA A. · 2014 to 2018
$624k
NCRR NIH HHS KL2 RR025006NCRR NIH HHS KL2RR025006NHLBI NIH HHS T32 HL007024NHLBI NIH HHS T32HL007024NIA NIH HHS K01 AG043501NIA NIH HHS K01AG043501NIA NIH HHS P30 AG021334NIA NIH HHS P30-AG021334NIA NIH HHS R01 AG042504NIA NIH HHS R01AG042504NIDDK NIH HHS K24 DK101828NIDDK NIH HHS K24DK101828NIDDK NIH HHS R01 DK072367NIDDK NIH HHS R01DK072367
6 · The paper itself

Abstract

BACKGROUND AND

objectivesPatients of all ages undergoing hemodialysis (HD) have a high prevalence of cognitive impairment and worse cognitive function than healthy controls, and those with dementia are at high risk of death. Frailty has been associated with poor cognitive function in older adults without kidney disease. We hypothesized that frailty might also be associated with poor cognitive function in adults of all ages undergoing HD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: At HD initiation, 324 adults enrolled (November 2008 to July 2012) in a longitudinal cohort study (Predictors of Arrhythmic and Cardiovascular Risk in ESRD) were classified into three groups (frail, intermediately frail, and nonfrail) based on the Fried frailty phenotype. Global cognitive function (3MS) and speed/attention (Trail Making Tests A and B [TMTA and TMTB, respectively]) were assessed at cohort entry and 1-year follow-up. Associations between frailty and cognitive function (at cohort entry and 1-year follow-up) were evaluated in adjusted (for sex, age, race, body mass index, education, depression and comorbidity at baseline) linear (3MS, TMTA) and Tobit (TMTB) regression models.

resultsAt cohort entry, the mean age was 54.8 years (SD 13.3), 56.5% were men, and 72.8% were black. The prevalence of frailty and intermediate frailty were 34.0% and 37.7%, respectively. The mean 3MS was 89.8 (SD 7.6), TMTA was 55.4 (SD 29), and TMTB was 161 (SD 83). Frailty was independently associated with lower cognitive function at cohort entry for all three measures (3MS: -2.4 points; 95% confidence interval [95% CI], -4.2 to -0.5; P=0.01; TMTA: 12.1 seconds; 95% CI, 4.7 to 19.4; P<0.001; and TMTB: 33.2 seconds; 95% CI, 9.9 to 56.4; P=0.01; all tests for trend, P<0.001) and with worse 3MS at 1-year follow-up (-2.8 points; 95% CI, -5.4 to -0.2; P=0.03).

conclusionsIn adult incident HD patients, frailty is associated with worse cognitive function, particularly global cognitive function (3MS).

Indexed as

CognitionHealth StatusRenal DialysisAdultAgedAttentionCognition DisordersFemaleHealth Status IndicatorsHumansKidney Failure, ChronicLinear ModelsLongitudinal StudiesMaleMarylandMiddle Agedafrican americanblackcognitiondementiadepressionepidemiology and outcomesESRDfrailtyhemodialysiskidney failure, chronicrenal dialysis

Identifiers

PMID26573615
PMCPMC4670760

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.