A comparison of end-stage renal disease and Alzheimer’s disease in the elderly through a comprehensive geriatric assessment

Abstract

The management of geriatric HD patients is substantially complex. Depression, cognitive impairment and decrease in functional capacity can often be overlooked, so findings may be ascribed to underlying kidney impairment. Therefore, comprehensive geriatric assessment should be regularly performed in HD patients in order to detect problems at an early stage, to take necessary preventative measures, to initiate treatment as soon as possible and to enhance quality of life.

Comprehensive geriatric assessment: comparison of elderly hemodialysis patients and primary care patients

“…A significantly higher percentage of HD patients had a Lawton score 6 in comparison to primary care patients and similar Lawton scores were recorded in other studies. 14,39 This is in accordance with the finding that 9.4% of our HD patients used a walking device but none of the primary care patients. In addition, ''The Timed Up and Go test'' showed that 24.5% of HD patients needed more than 20 s to perform this test in contrast to 13% of elderly patients treated in primary health care (p50.0001).…”

“…Previous studies either applied CGA only in HD patients 9 or compared HD patients with patients suffering from some other disease (cancer, Alzheimer) who were more severely ill than the dialysis patients. 13,14 Despite these shortcomings, our study confirmed the view highlighted in a several other studies on the feasibility and significance of CGA in HD patients. As CGA encompasses not only medical issues but all aspects of a patient's care, it enables both professionals and caregivers to identify problems that would not be revealed by standard assessment of HD, which is primarily directed to ESRDassociated disorders and quality of HD treatment.…”

“…Using ADL, Parlevliet et al 13 reported significantly more independence in HD patients than in control patients. On the contrary, Soysal et al 14 found significantly lower ADL scores in elderly HD patients compared to a control group consisting of elderly patients with normal kidney function hospitalized at a geriatric clinic. However, diabetes and congestive heart failure were more frequent in their participants than in our HD patient group.…”

“…8 Decreased functional capacity, sensory deficits, cognitive impairment and depression have frequently been found in hemodialysis (HD) patients [9][10][11] but only a few studies used comprehensive geriatric assessment (CGA) to evaluate HD patients. [11][12][13][14] CGA is a multidimensional procedure designed to evaluate an older person's physical health, functional ability, cognition and mental health, and socioenvironmental circumstances, as well as an extensive review of prescriptions. It was developed in order to improve coordination and integration of treatment and follow-up of elderly patients, together with the outcome.…”

Screening of Cognitive Impairment in the Dialysis Population: A Scoping Review

“…There were 46 studies meeting the inclusion criteria for final analysis [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55]. An overview of the reviewed articles is presented in Table 2.…”