Related factors on decreased activity of daily living in older patients with chronic kidney disease

Abstract

Background: Older patients with chronic kidney disease(CKD) have significant decline of activity of daily living(ADL). This study aimed to investigate the factors associated with decreased ADL in older patients with CKD. Methods: A cross-sectional study was conducted between September 1,2013 and June 30, 2014 in West China Hospital of Sichuan University and Kangfu Kidney Disease Hospital in Chengdu. All patients were older than 60 years with CKD. They received a comprehensive geriatric assessment. Contents of the survey include: a) general survey; b) laboratory parameters in the last 3 months; c)the comprehensive geriatric assessment indexes. Statistical analyses were performed with SPSS software, version 17.0. Results: A total of 542 patients were included in this study, of whom 332 were male and 210 female. The mean age was 76.1±8.9 years, with a median age of 76 years(60 ~ 101 years old). Univariate analysis showed that the difference of age, marital status, serum albumin, risk of malnutrition, malnutrition, cognitive function, depression score, comorbidity index, subjective support and the use of social support was statistically significant (P<0.05). Multiple logistic regression analysis showed that independent factors associated with the ADL impairment in the older patients with CKD included age [(70~79 years old OR=1.81,95% CI: 1.01-3.25), ≥ 80 years old OR=5.42,95% CI: 2.99-9.81)], marital status (OR=1.90,95 % CI: 1.15-3.15), depression (OR=1.33,95% CI: 1.22-1.44), risk of malnutrition (OR=2.81,95% CI: 1.70-4.65) and malnutrition (OR=5.13,95%CI:2.51-10.50). Conclusion: The factors associated with the decreased ADL in older patients with CKD include age, being widowed, depression, and poor nutritional status. So, to strengthen nutritional status, reduce loneliness, maintain good psychological condition can reduce the decline of ADL for older adults with CKD.