Awareness and cognitive status of older patients with chronic cardiorenal syndrome in terms of patient-centered approach

Type of funding sources: None.

A patient-centered approach is the basis for older patients with cardiovascular comorbidity. Collaborative decision making is especially important for older patients with chronic kidney disease (СKD).

The aim of the study was to study the possibilities and difficulties of a patient-centered approach in older patients with chronic cardiorenal syndrome.

Material and methods. 214 older patients with stable cardiovascular disease (106 males, mean age was 69.5 ± 7.6 years) were studied. CKD was diagnosed and classified according to the KDIGO guidelines (2012). Charlson comorbidity index (CCI) was estimated. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating scale (CDR). Assessment of socio-demographic characteristics and awareness of patients was determined by questionnaires and interviews. Follow-up period was 12 months.

Results. CKD was observed in 144 (67.3%) patients with stable cardiovascular disease. A third of older patients with CKD (48; 33.3%) were informed about impaired renal function (n = 144), and only 23 (16%) older patients with CKD, along with observation by a therapist, consulted a nephrologist . Only half of older patients with cardiovascular pathology, regardless of the presence of CKD, know their cholesterol level and their cardiovascular risk. In 70 (48.6%) older patients with stable cardiovascular pathology and CKD, pre-dementia cognitive impairment was observed, in 28 (19.4%) - mild dementia. A third of older patients with cardiovascular pathology and CKD (47; 32.6%) still have questions about their health. 112 (77.8%) patients would like to be able to remotely communicate with medical personnel in case of health issues. At the same time, only 37 (25.7%) patients with CKD are ready to attend full-time schools for patients.

Conclusion. Cognitive impairments and low awareness of older patients with chronic cardiorenal syndrome complicate the implementation of a patient-centered approach.