UTSW Research: Dementia risk, depression, and more
Studies investigate link between chronic kidney disease and cognitive impairment, impact of sleep on major depressive disorder, and regional differences in colon cancer surgery
Chronic kidney disease severity increases dementia risk
Tens of millions worldwide have dementia, neurodegenerative diseases that affect memory, thinking, and daily routines. Chronic kidney disease (CKD) has been identified as a risk factor for dementia and has been associated with dementia symptoms, such as cognitive decline and impairment. However, it has been unclear how severity of CKD might affect dementia risk.
To find out, three UT Southwestern Medical Center researchers and colleagues across the U.S. studied data from 5,607 participants in the Chronic Renal Insufficiency Cohort Study, a long-term study launched in 2001 to better understand CKD and its health risks. The participants underwent a series of cognitive tests upon enrolling in the study, along with assessments of kidney function, including their estimated glomerular filtration rate (eGFR) and urinary protein to creatinine ratio (UPCR). They were then followed for up to six years, with cognitive testing repeated every year or two.
Results published in JAMA Network Open revealed that the worse the patients’ kidney function was at baseline, the higher their chances of developing cognitive impairment. These findings suggest kidney function should be an important consideration when predicting dementia risk in CKD patients.
UTSW researchers who contributed to this study are Jing Chen, M.D., Professor of Internal Medicine in the Division of Nephrology, the Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, and in the Peter O’Donnell Jr. School of Public Health; Jiang He, M.D., M.S., Ph.D., Chair of Epidemiology in the O’Donnell School of Public Health and Professor of Internal Medicine and Neurology; and Changwei Li, M.D., Ph.D., M.P.H., Associate Professor of Epidemiology in the O’Donnell School of Public Health.
Poor sleep quality linked with depression relapse
Major depressive disorder (MDD) affects about 5% of individuals each year, making it one of the leading causes of disability worldwide. Sleep disturbances have been associated with worse outcomes in MDD. However, few studies have examined how changes in sleep rhythms affect the risk of MDD relapse after effective treatment.
A team of researchers, including Jane Foster, Ph.D., Professor of Psychiatry and an Investigator in the Peter O’Donnell Jr. Brain Institute at UT Southwestern, helped answer this question with data gathered from 102 patients seen for MDD at five clinics across Canada. After testing at baseline showed all of the patients were in remission, they wore actigraphs – devices that measure movement – at night to determine their sleep quality. Each participant was screened regularly for MDD using a survey as well as other markers for relapse, including hospitalization or medication changes for worsening depression symptoms and emerging suicidal ideation.
Results published in JAMA Psychiatry indicated that markers of poor sleep quality gathered from the actigraph were all strong predictors of MDD relapse, including waking soon after sleep onset, lower sleep regularity, and high nighttime activity. The researchers suggest that sleep quality measurements could eventually be used to identify high-risk individuals and enable timely, personalized MDD relapse prevention.
Delays in colon cancer surgery vary by region
Colon cancer is the third-most common and second-deadliest cancer in the U.S. Most patients undergo surgery to remove the primary tumor and associated lymph nodes. Although timely access to treatment has been well recognized as improving outcomes, surgical delays for colon cancer are common. Few studies have examined how these delays differ regionally and what differences might contribute.
A national team of researchers including Nina Sanford, M.D., Associate Professor of Radiation Oncology and Chief of the Gastrointestinal Radiation Oncology Service at UT Southwestern, investigated this question using data from 664,312 colon cancer patients gathered from the National Cancer Database, a collection of hospital registry information from more than 1,500 Commission on Cancer-accredited facilities. The scientists parsed data from 2004 to 2021 into the nine regions covered by the U.S. Census.
According to their findings, published in Public Health, the proportion of patients experiencing surgical delays of more than eight weeks rose from 4.5% in 2004 to 12.2% in 2021. Delays were most common in New England, and patients who were Black, American Indian/Alaska Native/Aleut/Eskimo, Asian American, or not on private insurance were more likely to experience delays. The study authors suggest targeted strategies are needed to address systemic and regional barriers to timely surgical treatment for colon cancer patients.
About UT Southwestern Medical Center 
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 24 members of the National Academy of Sciences, 25 members of the National Academy of Medicine, and 13 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,300 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians in more than 80 specialties care for more than 143,000 hospitalized patients, attend to more than 470,000 emergency room cases, and oversee nearly 5.3 million outpatient visits a year.