Age and Cognitive Impairment in Dialysis Patients: A Cross-Sectional Analysis

Background: Cognitive impairment is a frequent yet underrecognized complication in dialysis patients, adversely affecting quality of life and clinical outcomes. With the growing prevalence of chronic kidney disease (CKD), understanding the relationship between dialysis and cognitive decline is increasingly important. Methods: This cross-sectional study was conducted in 3 major nephrology centers in Türkiye. Cognitive function was assessed using the AD8 Dementia Screening Interview. Demographic, clinical, laboratory data, and dialysis adequacy (Kt/V) were analyzed for associations with cognitive impairment. Results: A total of 261 dialysis patients were included (54.4% male; median age: 56 years, range 18-89; 29.1% ≥65 years). Among them, 57.9% received hemodialysis and 42.1% peritoneal dialysis, with a median kidney replacement therapy duration of 3 years. Cognitive impairment was present in 63.6% of patients. These patients had a longer CKD duration (10 vs. 6 years, P < .001) but lower hypertension prevalence (65.2% vs. 84.4%, P = .001). Cognitive decline was more common in hemodialysis patients (66.3% vs. 43.2%, P < .001) and associated with lower hemoglobin (P = .033) and sodium levels (P = .019). In the multivariable logistic regression model, age was not an independent predictor (P = .315); correlates of cognitive impairment included longer CKD duration (P = .001), hemodialysis modality (P = .003), and lower sodium levels (P = .014). Conclusion: Cognitive impairment was highly prevalent among dialysis patients, independent of age. Recognition of modifiable risk factors may help guide multidisciplinary strategies to improve cognitive and overall patient outcomes. Cite this article as: Yıldırım S, Erdut A, Altunok M, et al. Age and cognitive impairment in dialysis patients: a cross-sectional analysis. Turk J Nephrol. Published online February 24, 2026. doi: 10.5152/turkjnephrol.2026.251169