Difficulty in activities of daily living and falls in patients undergoing hemodialysis: A cross‐sectional study with nondialysis controls

Abstract

Introduction Impaired activities of daily living (ADL) and falls are important issues in hemodialysis patients. So far, information is limited regarding self‐reported difficulty with ADL (ADL difficulty) in hemodialysis patients. Then, we compared the degree of ADL difficulty and the prevalence of fallers between hemodialysis patients and a nondialyzed control group. Also, the possible association between ADL difficulty and falls was examined. Methods This was a single center, cross‐sectional study including two groups of outpatients aged 50 years or older; 209 prevalent hemodialysis patients, and 139 nonrenal patients with diabetes mellitus, hypertension, and/or dyslipidemia (control group). ADL difficulty score was evaluated by a 48‐item questionnaire including six subscales of ADLs namely locomotion, eating, toileting, dressing, bathing, and grooming. Experience of falls in the previous year period was examined by a questionnaire. Findings The two groups did not differ significantly in age or sex. The hemodialysis group had a higher median (interquartile range) total score of ADL difficulty than the control group [10 (2–39) vs. 2 (0–10); p < 0.001] and a higher prevalence of fallers (73/209, 34.9% vs. 16/139, 11.5%; p < 0.001). In multivariable‐adjusted linear regression analyses, history of falls was independently associated with a higher score of ADL difficulty for total or each of the six subscales. Discussion The hemodialysis patients had a significantly higher ADL difficulty and a higher prevalence of fallers than the control group. Self‐reported ADL difficulty and falls were closely linked regardless of the patient group.

Patient‐reported difficulty in activities of daily living and corresponding muscle weakness in elderly patients undergoing haemodialysis

“…This was a single‐centre, cross‐sectional study in elderly haemodialysis patients who were selected from the participants of our previous study named “Protect Patients from ADL Problems and Falls (PPAP&F)” 3 . We asked the haemodialysis patients of the PPAP&F study aged 65 years or older to participate in this study, in which muscle strength and Barthel Index were additionally measured.…”

Nutritional Status Association With Sarcopenia in Patients Undergoing Maintenance Hemodialysis Assessed by Nutritional Risk Index

“…Diabetes mellitus was defined based on the American Diabetes Association criteria or treatment for diabetes mellitus (22). Past history of cerebrovascular disease was defined as prior occurrence of intracerebral hemorrhage, transient ischemic attack, subarachnoid hemorrhage, and/or ischemic stroke (23,24).…”

“…The level of albumin in serum was analyzed using a bromocresol purple method, while that of the serum standard (low-sensitive) Creactive protein (CRP) was analyzed using a latex agglutination immunoassay (reference range; 0-4.5 mg/L) at the hospital. Other standard laboratory parameters including levels of total cholesterol, creatinine, and hemoglobin were analyzed by use of a routine laboratory method at the hospital (23,24).…”

Relationships between frailty and exercise capacity in patients undergoing hemodialysis: A cross‐sectional study

“…Progression in the cycle of frailty, decrease in physical performance, such as exercise capacity and walking ability. A decline in ADL and physical activity are associated with high prevalence of falls 12 and post‐dialysis fatigue, 13 further causing dysfunction. Low exercise capacity in HD patients is correlated with low physical function and activity, 14 and frailty components, including physical function and activity, are partly associated with peakVO 2 .…”