Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
Clin Interv Aging. 2020 May 1;15:609-618. doi: 10.2147/CIA.S249137. eCollection 2020.
Elderly people are at increased risk of falls, disability and death due to reduced functional reserve, decline in multiple systems functions, which affects their activities of daily living (ADL) and eventually develop into frailty. The ADL assessment is conducive to early detection to avoid further serious situations. Previous studies on patients' activities of daily living with chronic kidney disease (CKD) are mainly focused on dialysis patients. Little information is available on non-dialysis patients.
A total of 303 elderly patients with CKD stage 3-5 who were admitted to our hospital were selected. ADL evaluation was performed on patients at admission, with Barthel index (BI) as the evaluation tool. They were divided into two groups based on BI (≥60 and <60). Demographic information, lifestyle and clinical profile were collected. The risk factors related to ADL were analyzed by univariate and multivariate models.
The data of 303 patients enrolled in this study were analyzed. The average age of patients was 84.48± 7.14 years and 62.05% were male. There were 88 patients (29.04%) in BI <60 group and 215 patients (70.96%) in the BI ≥60 group. The average age of subjects in the two groups was 87.47 ± 5.85 years and 83.26± 7.28 years, respectively. On univariate analysis, ADL impairment was associated with many factors, such as age, body mass index, blood lipid, heart rate, smoking history, Charlson comorbidity index (CCI), hemoglobin, serum albumin, BNP, eGFR, etc. Multivariate logistic regression showed that age (OR 1.08, 95% CI 1.00-1.17, P=0.0390), Charlson comorbidity index (OR 4.75, 95% CI 1.17-19.30, P=0.0295), and serum albumin (OR 0.80, 95% CI 0.70-0.92, P=0.0012) were the independent risk factors of ADL impairment.
Decline of ADL in CKD patients was independently correlated with age, Charlson comorbidity index and serum albumin. ADL and its influential factors in the elderly CKD patients deserve further attention.
老年人由于功能储备减少、多个系统功能下降，跌倒、残疾和死亡的风险增加，这影响了他们的日常生活活动（ADL），最终导致虚弱。ADL 评估有助于早期发现，避免进一步的严重情况。以前关于慢性肾脏病（CKD）患者日常生活活动的研究主要集中在透析患者上。关于非透析患者的信息很少。
共纳入我院收治的 303 例 CKD 3-5 期老年患者。入院时对患者进行 ADL 评估，以 Barthel 指数（BI）为评估工具。根据 BI（≥60 和<60）将患者分为两组。收集患者的人口统计学信息、生活方式和临床特征。采用单因素和多因素模型分析 ADL 的相关危险因素。
对本研究纳入的 303 例患者的数据进行分析。患者平均年龄为 84.48±7.14 岁，男性占 62.05%。BI<60 组 88 例（29.04%），BI≥60 组 215 例（70.96%）。两组患者的平均年龄分别为 87.47±5.85 岁和 83.26±7.28 岁。单因素分析显示，ADL 受损与年龄、体重指数、血脂、心率、吸烟史、Charlson 合并症指数（CCI）、血红蛋白、血清白蛋白、BNP、eGFR 等多个因素有关。多因素 logistic 回归显示，年龄（OR 1.08，95%CI 1.00-1.17，P=0.0390）、Charlson 合并症指数（OR 4.75，95%CI 1.17-19.30，P=0.0295）和血清白蛋白（OR 0.80，95%CI 0.70-0.92，P=0.0012）是 ADL 受损的独立危险因素。
CKD 患者 ADL 下降与年龄、Charlson 合并症指数和血清白蛋白独立相关。老年 CKD 患者的 ADL 及其影响因素值得进一步关注。
