Abstract: Objective  This study aimed to investigate the current status of cognitive frailty (CF) in maintenance hemodialysis (MHD) patients and to analyze the influencing factors for CF.  Methods  A total of 258 MHD patients from July to October 2022 were recruited by a convenient sampling method. CF was assessed using the Montreal cognitive assessment (MoCA), frailty phenotype assessment, and clinical dementia rating (CDR) scale. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for CF. A CF risk prediction model was then developed, and a nomogram was constructed. The performance of the nomogram was assessed using area under the curve and calibration plots.  Results  The prevalence of CF in the surveyed MHD patients was 16.67%. Multivariate logistic regression revealed that the calf muscle circumference (OR=0.938, 95% CI:0.883～0.996,P=0.038), five-times-sit-to-stand test (OR=1.098,95% CI:1.023～1.178,P=0.009), the sarcopenia screening scale of SARC-F score (OR=0.938,95% CI:0.883～0.996,P=0.038), and the geriatric depression scale of GDS-15 score (OR=0.938,95% CI:0.883～0.996,P=0.038) were the independent factors influencing CF in MHD patients. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for CF, and a CF risk prediction model and a nomogram were then developed. The performance assessment of the nomogram showed that the area under the curve was 0.842 (95% CI:0.779～0.905) and the Hosmer and Lemeshow goodness of fit test was c2=5.163 and P=0.740.  Conclusion  The prevalence of CF is high in MHD patients. Healthcare professionals should prioritize the sarcopenia and depression screening and the related somatic measures to enable early identification and intervention of CF, thus delaying the onset and progression of CF in MHD patients.

Key words: Maintenance hemodialysis; , Cognitive frailty; , Risk factors; , Nomogram