Hartmann Erica L, Kitzman Dalane, Rocco Michael, Leng Xiaoyan, Klepin Heidi, Gordon Michelle, Rejeski Jack, Berry Michael, Kritchevsky Stephen
Department of Internal Medicine, Wake Forest University Health Sciences, Section on Nephrology, Medical Center Boulevard Winston-Salem, NC 27157, USA.
Clin J Am Soc Nephrol. 2009 Mar;4(3):588-94. doi: 10.2215/CJN.03860808. Epub 2009 Mar 4.
Although physical function is a major determinant of health outcomes and quality of life in older adults, standard tools for its assessment have not been routinely applied to the fastest growing segment of the kidney transplant candidate population, which is at high risk of comorbidity and disability--people over age 60. The objective of this study was to describe the baseline physical function in older adults with renal failure referred for transplantation and compare them with older adults with other significant comorbidity.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: An observational sample comparing physical performance in renal transplant candidates over age 60 (Renal Failure) to older people with diastolic heart failure (Heart Failure), chronic obstructive pulmonary disease (COPD), or at high risk for cardiovascular disease (High CV Risk) was studied.
Older people with Renal Failure were significantly impaired by objective measures of physical function, including lower Short Physical Performance Battery, slower gait speed, and lower grip strength.
Older people referred for renal transplantation had poorer physical performance than older adults with other common chronic diseases and may be at high risk for disability while awaiting transplantation.
尽管身体功能是老年人健康结局和生活质量的主要决定因素,但用于评估身体功能的标准工具尚未常规应用于肾脏移植候选人群中增长最快的部分,即60岁以上合并症和残疾风险较高的人群。本研究的目的是描述转诊接受移植的老年肾衰竭患者的基线身体功能,并将他们与患有其他严重合并症的老年人进行比较。
设计、地点、参与者及测量方法:对一个观察性样本进行了研究,该样本比较了60岁以上肾脏移植候选者(肾衰竭组)与患有舒张性心力衰竭(心力衰竭组)、慢性阻塞性肺疾病(慢性阻塞性肺疾病组)或心血管疾病高风险(心血管疾病高风险组)的老年人的身体表现。
通过身体功能客观指标评估发现,肾衰竭组老年人身体功能明显受损,包括短身体性能量表得分较低、步态速度较慢和握力较弱。
转诊接受肾脏移植的老年人身体表现比患有其他常见慢性病的老年人更差,在等待移植期间可能面临较高的残疾风险。