Impaired kidney function is associated with lower quality of life among community-dwelling older adults

BMC Geriatrics

Sara Lainez Martinez¹  Pedro Gil¹  Agnieszka Guligowska²  Tomasz Kostka²  Regina Roller-Wirnsberger³  Francesco Mattace-Raso⁴  Lisanne Tap⁴  Ellen Freiberger⁵  Robert Kob⁵  Axel C. Carlsson⁶  Johan Ärnlöv⁶  Rada Artzi-Medvedik⁷  Itshak Melzer⁸  Yehudit Melzer⁹  Gerhard Wirnsberger^1,10  Francesc Formiga^1,11  Rafael Moreno-González^1,11  Andrea Corsonello^1,12  Fabrizia Lattanzio^1,12  Paolo Fabbietti^1,13 

[1] Department of Geriatric Medicine, Hospital Clinico San Carlos, Madrid, Spain;Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland;Department of Internal Medicine, Medical University of Graz, Graz, Austria;Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands;Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging, Krankenhaus Barmherzige Brüder, Friedrich-Alexander Universität Erlangen-Nürnberg, Koberger Strasse 60, 90408, Nuremberg, Germany;Department of Medical Sciences, Uppsala University, Uppsala, Sweden;School of Health and Social Studies, Dalarna University, Falun, Sweden;Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden;Department of Nursing, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel;Department of Physical Therapy, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel;Department of Physical Therapy, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel;Department of Physical Therapy, Recanati School for Community Health Professions at the faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-sheva, Israel;Maccabi Health Organization, Negev district, Tel Aviv-Yafo, Israel;Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;Geriatric Unit, Internal Medicine Department, Bellvitge University Hospital – IDIBELL – L’Hospitalet de Llobregat, Barcelona, Spain;Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy;Italian National Research Center on Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy;Laboratory of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA, Via S. Margherita 5, 60124, Ancona, Italy;

关键词: Quality of life;    Chronic kidney disease;    Old adults;   

DOI  :  10.1186/s12877-020-01697-3

来源: Springer

【 摘 要 】

BackgroundQuality of life (QoL) refers to the physical, psychological, social and medical aspects of life that are influenced by health status and function. The purpose of this study was to measure the self-perceived health status among the elderly population across Europe in different stages of Chronic Kidney Disease (CKD).MethodsOur series consisted of 2255 community-dwelling older adults enrolled in the Screening for Chronic Kidney Disease (CKD) among Older People across Europe (SCOPE) study. All patients underwent a comprehensive geriatric assessment (CGA), including included demographics, clinical and physical assessment, number of medications taken, family arrangement, Geriatric Depression Scale (GDS), Cumulative Illness Rating Scale, History of falls, Lower urinary tract symptoms, and Short Physical Performance Battery (SPPB). Estimated glomerular filtration rate (eGFR) was calculated by Berlin Initiative Study (BIS) equation. Quality of life was assessed by Euro Qol questionnaire (Euro-Qol 5D) and EQ-Visual Analogue Scale (EQ-VAS). The association between CKD (eGFR < 60, < 45 ml or < 30 ml/min/1.73m2) and low EQoL-VAS was investigated by multivariable logistic regression models.ResultsCKD was found to be significantly associated with low EQoL-VAS in crude analysis (OR = 1.47, 95%CI = 1.16–1.85 for eGFR< 60; OR = 1.38, 95%CI = 1.08–1.77 for eGFR< 45; OR = 1.57, 95%CI = 1.01–2.44). Such association was no longer significant only when adjusting for SPPB (OR = 1.20, 95%CI = 0.93–1.56 for eGFR< 60; OR = 0.87, 95%CI = 0.64–1.18 for eGFR< 45; OR = 0.84, 95%CI = 0.50–1.42), CIRS and polypharmacy (OR = 1.16, 95%CI = 0.90–1.50 for eGFR< 60; OR = 0.86, 95%CI = 0.64–1.16 for eGFR< 45; OR = 1.11, 95%CI = 0.69–1.80) or diabetes, hypertension and chronic obstructive pulmonary disease (OR = 1.28, 95%CI = 0.99–1.64 for eGFR< 60; OR = 1.16, 95%CI = 0.88–1.52 for eGFR< 45; OR = 1.47, 95%CI = 0.92–2.34). The association between CKD and low EQoL-VAS was confirmed in all remaining multivariable models.ConclusionsCKD may significantly affect QoL in community-dwelling older adults. Physical performance, polypharmacy, diabetes, hypertension and COPD may affect such association, which suggests that the impact of CKD on QoL is likely multifactorial and partly mediated by co-occurrent conditions/risk factors.

【 授权许可】

CC BY