老年慢性肾脏病患者的老年综合征与健康相关生活质量。

Geriatric Syndromes and Health-Related Quality of Life in Older Adults with Chronic Kidney Disease.

机构信息

Section of Geriatric Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California.

Geriatric Research and Education Clinical Center, Veteran Affairs Palo Alto Health Care System, Palo Alto, California.

出版信息

Kidney360. 2023 Apr 1;4(4):e457-e465. doi: 10.34067/KID.0000000000000078. Epub 2023 Feb 14.

DOI:10.34067/KID.0000000000000078

PMID:36790849

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10278840/

Abstract

KEY POINTS

In older adults with CKD, geriatric syndromes are common and are associated with reduced quality of life. Addressing geriatric syndromes could potentially improve quality of life for older adults with CKD.

BACKGROUND

Geriatric syndromes, which are multifactorial conditions common in older adults, predict health-related quality of life (HRQOL). Although CKD is associated with lower HRQOL, whether geriatric syndromes contribute to HRQOL in CKD is unknown. Our objective was to compare associations of geriatric syndromes and medical conditions with HRQOL in older adults with CKD.

METHODS

This was a secondary analysis of a parallel-group randomized controlled clinical trial evaluating a 12-month exercise intervention in persons 55 years or older with CKD stage 3b–4. Participants were assessed for baseline geriatric syndromes (cognitive impairment, poor appetite, dizziness, fatigue, and chronic pain) and medical conditions (diabetes, hypertension, coronary artery disease, cancer, or chronic obstructive pulmonary disease). Participants' HRQOL was assessed with the Short Form Health Survey-36 (SF-36), EuroQol 5-Dimensions 5-Level, and the EuroQol Visual Analogue Scale. We examined the cross-sectional and longitudinal associations of geriatric syndromes and medical conditions with HRQOL using multiple linear regression.

RESULTS

Among 99 participants, the mean age was 68.0 years, 25% were female, and 62% were Black. Participants had a baseline mean of 2.0 geriatric syndromes and 2.1 medical conditions; 49% had ≥ two geriatric syndromes and ≥ two medical conditions concurrently. Sixty-seven (68%) participants underwent 12-month assessments. In models using geriatric syndromes and medical conditions as concurrent exposures, the number of geriatric syndromes was cross-sectionally associated with SF-36 scores for general health (=−0.385) and role limitations because of physical health (=−0.374) and physical functioning (=−0.300, all <0.05). The number of medical conditions was only associated with SF-36 score for role limitations because of physical health (=−0.205).

CONCLUSIONS

In older adults with CKD stage 3b–4, geriatric syndromes are common and are associated with lower HRQOL. Addressing geriatric conditions is a potential approach to improve HRQOL for older adults with CKD.

CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER

: NCT01462097; Registration Date–October 26, 2011.

摘要

要点

在患有 CKD 的老年人中，老年综合征很常见，并且与生活质量下降有关。解决老年综合征问题可能会提高患有 CKD 的老年人的生活质量。

背景

老年综合征是老年人中常见的多因素疾病，可预测健康相关生活质量（HRQOL）。尽管 CKD 与较低的 HRQOL 相关，但老年综合征是否会对 CKD 患者的 HRQOL 产生影响尚不清楚。我们的目的是比较老年综合征和医疗状况与患有 CKD 阶段 3b-4 的老年人的 HRQOL 之间的关联。

方法

这是一项平行组随机对照临床试验的二次分析，该试验评估了为期 12 个月的运动干预措施，对象为年龄在 55 岁或以上的患有 CKD 阶段 3b-4 的患者。参与者接受了基线老年综合征（认知障碍、食欲不振、头晕、疲劳和慢性疼痛）和医疗状况（糖尿病、高血压、冠状动脉疾病、癌症或慢性阻塞性肺疾病）的评估。参与者的 HRQOL 使用简短形式健康调查-36（SF-36）、欧洲五维健康量表 5 级（EQ-5D-5L）和欧洲五维健康量表视觉模拟量表（EQ-VAS）进行评估。我们使用多元线性回归法研究了老年综合征和医疗状况与 HRQOL 的横断面和纵向关联。

结果

在 99 名参与者中，平均年龄为 68.0 岁，25%为女性，62%为黑人。参与者的基线平均有 2.0 种老年综合征和 2.1 种医疗状况；49%的参与者同时存在≥两种老年综合征和≥两种医疗状况。67 名（68%）参与者进行了 12 个月的评估。在使用老年综合征和医疗状况作为并发暴露的模型中，老年综合征的数量与 SF-36 一般健康评分（=−0.385）和身体功能受限（=−0.374）和身体功能（=−0.300，均<0.05）呈横断面相关。医疗状况的数量仅与 SF-36 身体功能受限评分呈相关性（=−0.205）。