Promoting functioning and well-being in older CKD patients: review of recent evidence

Abstract

Osteoporosis, falls, sleep difficulty, cognitive impairment, and depressed mood are major clinical concerns in the geriatric population that are physiologically and psychologically based and are often interrelated. All of these issues have implications for patients' daily functioning and quality of life (QOL). This review synthesizes recent evidence about these prominent issues in geriatric care and related implications for care of older patients with chronic kidney disease (CKD). Recent evidence about pre-dialysis and dialysis treatment strategies that may help to optimize management of older patients is also considered. Although elderly patients often report better psychosocial adjustment to dialysis than do younger patients, physical functioning and cognitive functioning losses challenge the QOL of many elderly persons. Early management of CKD and attention to anemia, consideration of the benefits of peritoneal dialysis compared with hemodialysis, and inclusion of some form of exercise or regular physical activity in routine care provide key opportunities to enhance the functioning and well-being of older patients.

Fatores associados com a qualidade de vida relacionada à saúde de idosos em hemodiálise

“…5,9,10,12,18,20,24 The specifi c dimensions of KDQOL-SF with the lowest mean scores were effects of kidney disease on daily life, burden of kidney disease, work status and patient satisfaction. The generic dimensions of SF-36 with the lowest scores were physical functioning, role-physical, and overall health rating.…”

“…Mapes et al 15 concluded that the PCS was the component of QoL most strongly associated with mortality. According to Kutner,10 although physical health status is compromised in elderly patients on dialysis, their mental health status is relatively preserved. There are no studies in Brazil on the impact of PCS and MCS on mortality in elderly patients on hemodialysis and further studies are needed to explore this relationship.…”

Untitled

“…This may be alleviated with the increase of knowledge related to gerontology, as well as supporting and helping issues of well-being in elderly people (Kutner, 2008). The ageing of society represents a socio-demographic change which has been increasing in recent decades.…”

Renal Replacement Therapy in the Elderly Population

“…Studies suggest that .45% of elderly patients undergoing dialysis have one or more falls per year (5,6). Falls are an important risk factor for fractures, future falls, and death in geriatric populations.…”