Habitual coffee consumption enhances attention and vigilance in hemodialysis patients

Acute Effects of Caffeine Ingestion on Postural Balance, Functional Capacity and Cognitive Function in Patients with End Stage Renal Disease

Patients with end stage renal disease (ESRD) display many cognitive and physiological alterations resulting from renal failure and physical inactivity. Caffeine intake has been reported to improve cognitive/physical performance in several studies. However, whether the benefits of caffeine intake apply to patients with ESRD remains unknown. The aim of the present study was to explore the effect of caffeine intake on postural balance, cognitive function and functional capacity in patients with ESRD. In a randomized order, 12 patients with ESRD (age: 33.85 ± 8.57 years; Female: 45.5%) performed a battery of tests after either caffeine (CF) (400 mg) or placebo (PLA) ingestion. Postural balance was evaluated using a stabilometric platform. Functional capacity was assessed with the sit-to-stand and up-and-go tests, and for cognitive performances, reaction time test and a vigilance test were used. Results showed a significant improvement in up-and-go test (p = 0.01) and sit-to-stand test performances with CF compared to PLA (p < 0.01). Time of reaction test and vigilance test (p < 0.01) performances were significantly higher with CF. No significant difference was observed in postural balance between CF and PLA. The results of this study suggest that acute caffeine ingestion positively enhances cognitive function and functional capacity in patients with ESRD.

The relationship between dietary patterns derived from inflammation and cognitive impairment in patients undergoing hemodialysis

Introduction

Dietary patterns were shown to be closely related to inflammation, which was independently associated with cognitive impairment (CI) in patients undergoing hemodialysis (HD). However, it remains unclear the influence of dietary patterns derived from inflammation on CI in this population. This study aimed to examine the association between dietary patterns derived from C-reactive protein (CRP) and interleukin-6 (IL-6) and CI in patients undergoing HD.

Methods

Dietary intake was obtained from the simplified quantitative food frequency questionnaire. Reduced rank regression (RRR) was used to extract two dietary patterns, with IL-6 and CRP as response variables. Cognitive function was examined by the Montreal Cognitive Assessment (Beijing version). Venous blood was drawn for measuring IL-6 and CRP levels. Multivariable logistic regression was used to investigate the association between dietary patterns and CI.

Results

Dietary pattern derived from IL-6 was not significantly associated with CI. The third quartile of dietary pattern, which used CRP as the response variable, significantly contributed to the increased risk of CI (AOR 8.62, 95% CI 1.47-50.67) after controlling age, sex, education level, marital status, and residential pattern (p-for-trend = 0.028). After considering hypertension and diabetes, physical activity level, anxiety and depression, smoking and drinking status, social support, energy intake, and the dietary pattern derived from IL-6 (p-for-trend = 0.026), the relationship between the dietary pattern derived from CRP and CI remained significant (AOR 14.54, 95% CI 1.40-151.13).

Conclusion

Dietary pattern associated with high CRP level, including high intake of rice, liquor, fruit, tea and coffee and low intake of dark vegetables and juice, contributed to the increased risk of CI. The association between the consumption of seafood, sweet beverages, and alcohol and CI is yet to be established. However, they may be dietary contributing factors to inflammation in patients undergoing HD.

The magical smell and taste: Can coffee be good to patients with cardiometabolic disease?

Coffee is a beverage consumed globally. Although few studies have indicated adverse effects, it is typically a beneficial health-promoting agent in a range of diseases, including depression, diabetes, cardiovascular disease, and obesity. Coffee is rich in caffeine, antioxidants, and phenolic compounds, which can modulate the composition of the gut microbiota and mitigate both inflammation and oxidative stress, common features of the burden of lifestyle diseases. This review will discuss the possible benefits of coffee on complications present in patients with diabetes, cardiovascular disease and chronic kidney disease, outwith the social and emotional benefits attributed to caffeine consumption.

Effects of Caffeinated and Decaffeinated Coffee on Hemodialysis-Related Headache (CoffeeHD): A Randomized Multicenter Clinical Trial

OBJECTIVES

Historically, headache was reported in up to 76% of hemodialysis patients. Some authors suggested that headache resulted from caffeine withdrawal. This study aims to compare the incidence of headache and hypotension between patients drinking regular or decaffeinated coffee during dialysis.

METHODS

One-hundred fifty-six patients were enrolled in this randomized, double-blind, placebo-controlled, multicenter study. Patients with atrial fibrillation were excluded. Group A was given 80 mL of regular coffee and group B 80 mL of decaffeinated coffee (placebo) in the middle of the session for 12 consecutive sessions. Ultrafiltration rate was fixed to a maximum of 13 mL/kg/hour. The primary outcome was the incidence of headache during dialysis.

RESULTS

A total of 139 patients completed the trial (6.4% vs. 15.4% of withdrawal in Groups A and B, respectively). The number of sessions with headache was not significantly different between Group A and B (33.3% vs. 37.1% respectively, P = .522), nor the number of sessions with hypotension (27% vs. 26% respectively, P = .539). In a subgroup analysis, headache tended to be more frequent in Group B (P = .06) in 2 categories of patients: those with the highest potassium dialysate (K = 2) and the non-hypertensive patients.

CONCLUSIONS

Headache occurred in 35% of patients during their chronic hemodialysis sessions. Caffeine intake did not prevent headache occurrence in these patients.

Association between caffeine intake and cognitive function in adults; effect modification by sex: Data from National Health and Nutrition Examination Survey (NHANES) 2013-2014

BACKGROUND & AIMS

The aim of this study was to evaluate the association between caffeine intake and cognitive function.

METHODS

In this cross sectional study, we used data from the 2013-2014 National Health and Nutritional Examination Surveys (NHANES). Our research subjects were 1440 adults aged ≥60 years. The individual's cognitive functions were evaluated using the Consortium to Establish a Registry for Alzheimer's disease (CERAD) Word List Learning Test, CERAD Word List Recall Test, Animal Fluency test, and Digit Symbol Substitution Test (DSST). Participants were categorized based on the quartiles of caffeine intake. In each dimension of cognitive, we calculated and used median value as cut-off point and assessed the association between each dimension (binary) and caffeine intake using multiple logistic regression analysis in different models.

RESULTS

In all of the dimensions, only the highest quartile of caffeine intakes was positively associated with the cognitive function in the crude model and also trend existed (P trend <0.05). After adjusting for potential confounders (age, sex, family income, education, marital status, history of disease, sleep disorders, thyroid problems, physical activity, social support, smoking, and some nutrients), the association was marginally significant in CERAD Word List Recall Test (P trend = 0.09), but was not significant in other dimensions of cognitive function. A statistically significant interaction was noted between caffeine intake and gender in relation to the CERAD Word List Recall Test (P = 0.02).

CONCLUSIONS

Generally, there was a weak positive association between caffeine intake and cognitive performance in older adults that modified by sex. So that, the relation was stronger among male than female.

Vigilance Decrement and Enhancement Techniques: A Review

This paper presents the first comprehensive review on vigilance enhancement using both conventional and unconventional means, and further discusses the resulting contradictory findings. It highlights the key differences observed between the research findings and argues that variations of the experimental protocol could be a significant contributing factor towards such contradictory results. Furthermore, the paper reveals the effectiveness of unconventional means of enhancement in significant reduction of vigilance decrement compared to conventional means. Meanwhile, a discussion on the challenges of enhancement techniques is presented, with several suggested recommendations and alternative strategies to maintain an adequate level of vigilance for the task at hand. Additionally, this review provides evidence in support of the use of unconventional means of enhancement on vigilance studies, regardless of their practical challenges.

Montreal Cognitive Assessment for cognitive assessment in chronic kidney disease: a systematic review

INTRODUCTION

There is evidence in the literature that cognitive impairment is more prevalent in individuals with chronic kidney disease (CKD) than in the general population. The Montreal Cognitive Assessment (MoCA) is an instrument with a good application profile for cognitive evaluation of patients with CKD-like impairments. The objective of this study is to perform a systematic review of MoCA use in the context of CKD.

METHOD

The keywords "Montreal Cognitive Assessment", "Kidney Disease" and "Chronic Kidney Disease" were used to search the databases. The inclusion criteria were: a) empirical articles; b) approach to cognitive impairment in CKD; c) papers in Portuguese and English.

RESULTS

The studies were mostly cross-sectional, published in medical journals, with research carried out mostly in Europe. About 45% of the studies had samples of less than 150 participants and variations in the prevalence of cognitive impairment were found ranging from 28.9% to 74.6%. The cutoff point for the identification of the impairment presented variation between the studies.

DISCUSSION

The results' analysis demonstrates the need for more complete studies on MoCA scoring and adaptation in its different versions. We recommend to the health professionals who will use the results in the clinical setting that the interpretation of the results be made in the light of studies more related to the context lived by the patients.

CONCLUSIONS

The instrument is efficient to be used in several stages and treatment modalities of the disease. We point to the need to adapt a cut-off point for the instrument in the different translations of the instrument.

Coffee consumption in hemodialysis patients: how many?

BACKGROUND AND AIMS

Coffee is one of the most widely consumed beverages worldwide. However, fluid intake restriction is an important and difficult challenge for hemodialysis (HD) patients. The aim of this study was to analyze the effect of coffee intake on hydration and nutritional parameters of HD patients.

METHODS

This was an observational, cross-sectional, multicenter study where 373 HD patients from 8 dialysis centers in Portugal were enrolled. A face-to-face questionnaire was applied and patient's clinical and body composition parameters were analyzed. The sample was divided into 3 groups depending on coffee intake: group 1-don't drink coffee, group 2-drink 1-2 coffees/day and group 3-drink 3 or more coffees/day. Laboratory and body composition parameters were registered in the month prior to the questionnaire application. Body composition was assessed with the Body Composition Monitor (BCM; Fresenius Medical Care Deutschland GmbH, Germany).

RESULTS

Patient's mean age was 67.2 ± 14.4 years and the mean HD vintage was 61.3 ± 56.2 months. Patients who reported drinking 3 or more coffees daily were younger, presented higher levels of potassium, phosphorus, diastolic BP, albumin and interdialytic weight gain (IDWG) and lower dialysis adequacy (Kt/V). Regarding body composition, patients in the group 3 showed higher body cell mass index (BCMI) and lean tissue index (LTI). On the other hand, the group 1 were the oldest, had a higher Kt/V, a lower diastolic blood pressure (BP) and potassium levels, whereas G2 presented a lower LTI, BCMI and IDWG.

CONCLUSIONS

Drinking 3 or more coffees daily increases the risk of a higher diastolic BP, potassium and IDWG in HD patients.

An association between dietary habits and traffic accidents in patients with chronic liver disease: A data-mining analysis

The incidence of traffic accidents in patients with chronic liver disease (CLD) is high in the USA. However, the characteristics of patients, including dietary habits, differ between Japan and the USA. The present study investigated the incidence of traffic accidents in CLD patients and the clinical profiles associated with traffic accidents in Japan using a data-mining analysis. A cross-sectional study was performed and 256 subjects [148 CLD patients (CLD group) and 106 patients with other digestive diseases (disease control group)] were enrolled; 2 patients were excluded. The incidence of traffic accidents was compared between the two groups. Independent factors for traffic accidents were analyzed using logistic regression and decision-tree analyses. The incidence of traffic accidents did not differ between the CLD and disease control groups (8.8 vs. 11.3%). The results of the logistic regression analysis showed that yoghurt consumption was the only independent risk factor for traffic accidents (odds ratio, 0.37; 95% confidence interval, 0.16-0.85; P=0.0197). Similarly, the results of the decision-tree analysis showed that yoghurt consumption was the initial divergence variable. In patients who consumed yoghurt habitually, the incidence of traffic accidents was 6.6%, while that in patients who did not consume yoghurt was 16.0%. CLD was not identified as an independent factor in the logistic regression and decision-tree analyses. In conclusion, the difference in the incidence of traffic accidents in Japan between the CLD and disease control groups was insignificant. Furthermore, yoghurt consumption was an independent negative risk factor for traffic accidents in patients with digestive diseases, including CLD.