Many Older Adults With CKD Functionally Impaired
Nearly 28% of study participants demonstrated difficulty with 1 or more activities of daily living, a history of falls, and cognitive impairment.
HealthDay News — Older adults with chronic kidney disease (CKD) have a considerable burden of functional impairment, according to research published online in the Journal of the American Geriatrics Society.
Rasheeda K. Hall, MD, MBA, from the Durham Veterans Affairs Medical Center in North Carolina, and colleagues implemented 2 innovative programs in the Veterans Health Administration that incorporate geriatric assessment into a nephrology visit. In one, a geriatrician used standardized geriatric assessment tools in a nephrology clinic among individuals with CKD aged 70 years and older (CGA-4-CKD). In the second, comprehensive appointments were used for individuals aged 75 years and older to conduct geriatric assessments and CKD care (Renal Silver). Data were included for 68 veterans with geriatric assessments through these programs.
The researchers found that 27.3% of the participants in CGA-4-CKD had difficulty with 1 or more activities of daily living (ADLs), history of falls, and cognitive impairment. In Renal Silver, 65.7%, 28.6%, and 51.6%, respectively, had ADL difficulty, falls, and cognitive impairment. In the CGA-4-CKD and Renal Silver programs, geriatric assessment guided care processes in 45.4% and 37.1%, respectively.
"Findings suggest there is a significant burden of functional impairment in older adults with CKD," the authors write. "Knowledge of this impairment is applicable to CKD management."
- Hall RK, Hainse C, Gorbatkin SM, et al. Incorporating Geriatric Assessment into a Nephrology Clinic: Preliminary Data from Two Models of Care. J Am Geriatr Soc. 2016; doi: 10.1111/jgs.14262