Abstract/Summary

Introduction: End-stage renal disease (ESRD) has been associated with a range of cognitive deficits, including impaired retrospective memory and attention. Prospective Memory (PM) is memory for future intentions, such as remembering to take medication on time. PM has not been examined in any ESRD patients, yet the implications upon diet and medication management could have potentially detrimental effects on patient welfare. This is the first study to examine PM in ESRD patients being treated with hemodialysis (HD). Methods: HD patients (n=18) were compared to age and education-matched controls (n=18) on a boardgame task that emulates a typical week of activities (i.e. grocery shopping, meetings with friends), requiring the participant to remember a series of upcoming tasks. Other measures were also examined, including general cognitive decline, measures of independent living, IQ and mood. Findings: Patients recalled significantly fewer upcoming events than the control group, suggesting an impairment of PM. No significant relationship was found between PM performance and any other measures, suggesting the difference between groups is likely due to the effects of ESRD, HD treatment or some associated comorbidity. Discussion: This is the first study to demonstrate a PM deficit in patients undergoing HD treatment. This finding contributes to the current knowledge of the cognitive profile of patients undergoing HD, whilst also highlighting the implications that a PM deficit may have on patient quality of life. The finding may go some way to explaining variances in patients’ ability to monitor and adhere to medication and dietary regimes, and ultimately, to live independently. The study also highlights the necessity of viewing treatment for ESRD as a holistic process to maximise patient wellbeing.