When performance and perception diverge: a comparison of self-report and objective measures of executive functioning in a hemodialysis population
Start Date
17-4-2026 1:30 PM
End Date
17-4-2026 2:30 PM
Description
Introduction: For patients receiving hemodialysis, neurocognitive and executive dysfunction is prevalent and arises from a number of factors, including chronic inflammation, cerebral vascular dysfunction, anemia, white matter injury, and uremic toxins. There is well-documented evidence of cognitive impairment, primarily in working memory and processing speed. However, the congruence of performance-based and self-report measures in this population remains limited. Existing studies suggest variable correspondence between objective cognitive performance and subjective executive complaints in other medically complex populations.
Objectives: The intent of the present study was to examine the prevalence of executive and cognitive impairment in individuals undergoing hemodialysis and the congruence between self-reported and objective measures using a brief, multimethod neuropsychological approach.
Methods: Neuropsychological data from adults undergoing outpatient hemodialysis who voluntarily participated in a research study were examined. The data presented here are part of a larger study on quality of life and biopsychosocial functioning in this population. The assessment battery included the Montreal Cognitive Assessment (MoCA) to assess global cognitive functioning, the Trail Making Test (TMT Parts A and B) to assess processing speed and cognitive flexibility, and the Behavior Rating Inventory of Executive Function–Adult Version (BRIEF-A) to evaluate everyday executive functioning from the patient’s perspective.
Results: The sample (N = 21) demonstrated global impairment on the MoCA (M = 22, SD = 2.78), with 76.2% below a cut-off of >24. TMT completion times were TMT-A: M = 81.61 seconds (SD = 54.68) and TMT-B: M = 183.29 seconds (SD = 102.53). There was no elevation on the BRIEF-A Global Executive Composite (GEC) scores (M = 49, SD = 8.48), with 4.8% endorsing significant executive difficulties. There was no significant association between BRIEF-A:S GEC and TMT-B scores ((X2 (1, N = 21) = 1.16, p = .283).
Conclusion: Conclusively, these results suggest that both global neurocognitive and executive dysfunction are prevalent among individuals receiving hemodialysis, and that insight into self-reported executive difficulties may differ, relating to reasons such as lack of access of awareness or denial of cognitive or psychological problems. Findings underscore the importance of integrating objective neuropsychological measures with self-report assessments when evaluating cognitive functioning in this population, as reliance on a single self-report modality may yield incomplete or misleading conclusions.
Embargo Period
5-20-2026
When performance and perception diverge: a comparison of self-report and objective measures of executive functioning in a hemodialysis population
Introduction: For patients receiving hemodialysis, neurocognitive and executive dysfunction is prevalent and arises from a number of factors, including chronic inflammation, cerebral vascular dysfunction, anemia, white matter injury, and uremic toxins. There is well-documented evidence of cognitive impairment, primarily in working memory and processing speed. However, the congruence of performance-based and self-report measures in this population remains limited. Existing studies suggest variable correspondence between objective cognitive performance and subjective executive complaints in other medically complex populations.
Objectives: The intent of the present study was to examine the prevalence of executive and cognitive impairment in individuals undergoing hemodialysis and the congruence between self-reported and objective measures using a brief, multimethod neuropsychological approach.
Methods: Neuropsychological data from adults undergoing outpatient hemodialysis who voluntarily participated in a research study were examined. The data presented here are part of a larger study on quality of life and biopsychosocial functioning in this population. The assessment battery included the Montreal Cognitive Assessment (MoCA) to assess global cognitive functioning, the Trail Making Test (TMT Parts A and B) to assess processing speed and cognitive flexibility, and the Behavior Rating Inventory of Executive Function–Adult Version (BRIEF-A) to evaluate everyday executive functioning from the patient’s perspective.
Results: The sample (N = 21) demonstrated global impairment on the MoCA (M = 22, SD = 2.78), with 76.2% below a cut-off of >24. TMT completion times were TMT-A: M = 81.61 seconds (SD = 54.68) and TMT-B: M = 183.29 seconds (SD = 102.53). There was no elevation on the BRIEF-A Global Executive Composite (GEC) scores (M = 49, SD = 8.48), with 4.8% endorsing significant executive difficulties. There was no significant association between BRIEF-A:S GEC and TMT-B scores ((X2 (1, N = 21) = 1.16, p = .283).
Conclusion: Conclusively, these results suggest that both global neurocognitive and executive dysfunction are prevalent among individuals receiving hemodialysis, and that insight into self-reported executive difficulties may differ, relating to reasons such as lack of access of awareness or denial of cognitive or psychological problems. Findings underscore the importance of integrating objective neuropsychological measures with self-report assessments when evaluating cognitive functioning in this population, as reliance on a single self-report modality may yield incomplete or misleading conclusions.