Quality of life and cognitive and functional performance of octogenarians and nonagenarians undergoing hemodialysis
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To evaluate the quality of life, cognitive and functional capacity of older adult patients undergoing hemodialysis who are 80 years of age or older and compare them to older adults without chronic kidney disease (CKD) treated at a geriatrics outpatient clinic.
First, 103 older adult patients undergoing hemodialysis and 103 older adults without CKD matched by gender and age were evaluated. Cognitive aspects as evaluated by the mini mental state examination, the Boston Naming Test and verbal fluency were analyzed; comorbidities according to the Charlson’s comorbidity index; social support through the Medical Outcomes Study scale; functional ability through the chair sit-to-stand and gait speed tests, as well as the basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and quality of life according to the Kidney Disease Quality of Life Short Form (KDQOL SF-36) questionnaires.
The hemodialysis group had a higher rate of comorbidities (7.8 ± 2.4 vs. 5.8 ± 2.3, p < 0.001). In the multiple logistic regression analysis, the group undergoing hemodialysis presented a ninefold greater chance of dependence for IADL than controls, a 4.3 and 3.2 times greater chances for inadequacy on the gait speed and chair sit-to-stand tests, respectively, as well as a 4.4-fold higher risk of cognitive decline on the verbal fluency test.
Long-lived patients undergoing hemodialysis presented worse quality of life and functional and cognitive performance compared to long-term patients attended at the outpatient clinic, indicating that preventive and protective measures should be considered and implemented.
KeywordsChronic kidney disease Renal replacement therapy Older adults Dialysis Quality of life Physical evaluation Mental assessment
OTP, AGSB, and RS conceived the study project, participated in data collection and study design, and performed statistical analysis, interpretation of data, and drafting of the manuscript; BFC, IPM, AFM, and DAB participated in the data collection and interpretation; all authors read and approved the final manuscript.
This study received no funding.
Compliance with ethical standards
Conflict of interest
The authors declare they have no conflicts of interest.
All procedures performed in the study involving human participants are in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its subsequent amendments or comparable ethical standards.
Informed consent was individually obtained from all participants included in the study.
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