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2 results on '"IADLs impairment"'

1. Functional impairment is associated with an increased risk of mortality in patients on chronic hemodialysis.

Author

Bossola, Maurizio, Di Stasio, Enrico, Antocicco, Manuela, Pepe, Gilda, Tazza, Luigi, Zuccalà, Giuseppe, and Laudisio, Alice

Subjects
HEMODIALYSIS, GERIATRIC assessment, BLOOD filtration, GERIATRIC Depression Scale, FUNCTIONAL assessment, TREATMENT of chronic kidney failure, ACTIVITIES of daily living, CHRONIC kidney failure, MENTAL depression, LONGITUDINAL method, SURVIVAL, CROSS-sectional method, PSYCHOLOGY
Abstract

Background: Functional impairment is associated with adverse outcomes in older people, as well as in patients on chronic hemodialysis. The aim of the present study was to determine the characteristics associated with functional impairment in chronic hemodialysis, and to evaluate if functional impairment represents a risk factor for reduced survival in chronic hemodialysis.Methods: All 132 chronic hemodialysis referring to the Hemodialysis Service of the Catholic University, Rome, Italy between November 2007 and May 2015 were included. All patients underwent comprehensive geriatric assessment; functional ability was estimated using two questionnaires exploring independency in bathing, dressing, toileting, transferring, continence, feeding (ADLs), and independency in using the telephone, shopping, food preparation, housekeeping, laundering, traveling, taking medications, and handling finances (IADLs). Functional impairment was diagnosed in presence of dependence in one or more ADLs/IADLs. Mood was assessed using the 30-item Geriatric Depression Scale. Logistic regression was used to evaluate factors associated with functional impairment. The association between functional impairment and survival was assessed by Cox regression.Results: ADLs impairment was present in 34 (26 %) participants, while IADLs impairment was detected in 64 (48 %) subjects. After a follow up of 90 months, 55 (42 %) patients died. In logistic regression, depressive symptoms were associated with ADLs and IADLs impairment (OR 1.12; 95 % CI = 1.02-1.23; OR 1.16; 95 % CI = 1.02-1.33; respectively). In Cox regression, ADLs impairment was associated with mortality (HR 2.47; 95 % CI-1.07-5.67) while IADLs impairment was not associated with reduced survival (HR .80; 95 % CI-.36-1.76).Conclusions: Functional impairment is associated with depressive symptoms; also, impairment in the ADLs represents a risk factor of reduced survival in chronic hemodialysis. These associations and their potential implication should be assessed in dedicated studies. [ABSTRACT FROM AUTHOR]

Published
2016
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2. Functional impairment is associated with an increased risk of mortality in patients on chronic hemodialysis

Author

Giuseppe Zuccalà, Manuela Antocicco, Alice Laudisio, Enrico Di Stasio, Luigi Tazza, Maurizio Bossola, and G Pepe

Subjects
Adult, Male, medicine.medical_specialty, Activities of daily living, medicine.medical_treatment, Rome, 030232 urology & nephrology, End stage renal disease, 03 medical and health sciences, End-stage renal disease, 0302 clinical medicine, IADLs impairment, Renal Dialysis, Risk Factors, Internal medicine, Surveys and Questionnaires, Activities of Daily Living, Medicine, Humans, Settore MED/14 - NEFROLOGIA, 030212 general & internal medicine, Functional ability, Prospective Studies, Risk factor, Mortality, Renal Insufficiency, Chronic, Survival rate, Geriatric Assessment, Aged, Aged, 80 and over, ADLs, business.industry, Proportional hazards model, Depression, Hemodialysis, Nephrology, Middle Aged, Survival Rate, Cross-Sectional Studies, Geriatric Depression Scale, Female, business, human activities, Research Article
Abstract

Background Functional impairment is associated with adverse outcomes in older people, as well as in patients on chronic hemodialysis. The aim of the present study was to determine the characteristics associated with functional impairment in chronic hemodialysis, and to evaluate if functional impairment represents a risk factor for reduced survival in chronic hemodialysis. Methods All 132 chronic hemodialysis referring to the Hemodialysis Service of the Catholic University, Rome, Italy between November 2007 and May 2015 were included. All patients underwent comprehensive geriatric assessment; functional ability was estimated using two questionnaires exploring independency in bathing, dressing, toileting, transferring, continence, feeding (ADLs), and independency in using the telephone, shopping, food preparation, housekeeping, laundering, traveling, taking medications, and handling finances (IADLs). Functional impairment was diagnosed in presence of dependence in one or more ADLs/IADLs. Mood was assessed using the 30-item Geriatric Depression Scale. Logistic regression was used to evaluate factors associated with functional impairment. The association between functional impairment and survival was assessed by Cox regression. Results ADLs impairment was present in 34 (26 %) participants, while IADLs impairment was detected in 64 (48 %) subjects. After a follow up of 90 months, 55 (42 %) patients died. In logistic regression, depressive symptoms were associated with ADLs and IADLs impairment (OR 1.12; 95 % CI = 1.02–1.23; OR 1.16; 95 % CI = 1.02–1.33; respectively). In Cox regression, ADLs impairment was associated with mortality (HR 2.47; 95 % CI–1.07–5.67) while IADLs impairment was not associated with reduced survival (HR .80; 95 % CI–.36–1.76). Conclusions Functional impairment is associated with depressive symptoms; also, impairment in the ADLs represents a risk factor of reduced survival in chronic hemodialysis. These associations and their potential implication should be assessed in dedicated studies.

Published
2016

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