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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Comprehensive geriatric assessment in the hemodialysis elderly population
Filippo Aucella1, Laura Stoico, Antonio Cicchella
1Nephrology and Dialysis Unit, Department of Medical Sciences, Research Institute Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy. f.aucella@operapadrepio.it
Journal of Nephrology
|September 14, 2012
Summary
The Multidimensional Prognostic Index (MPI) effectively assesses older patients with end-stage renal disease undergoing dialysis. This tool aids in defining comorbidity and guiding multidisciplinary care for these complex patients.
Area of Science:
- Gerontology
- Nephrology
- Internal Medicine
Background:
- Older adults with end-stage renal disease (ESRD) often have complex health needs.
- Comprehensive Geriatric Assessment (CGA) is crucial for evaluating these patients.
- The Multidimensional Prognostic Index (MPI) is a tool derived from CGA.
Purpose of the Study:
- To evaluate the utility of the MPI in assessing comorbidity and the need for multidisciplinary care in older ESRD patients on chronic hemodialysis.
- To compare MPI scores in ESRD patients with geriatric patients without renal impairment.
Main Methods:
- Cross-sectional study of 162 patients (103 aged 65+ with ESRD on hemodialysis) and 250 controls.
- Standardized CGA collected data on clinical, cognitive, functional, nutritional status, comorbidity, medications, and social support.
- MPI was calculated using CGA data.
Main Results:
- Most dialysis patients (58.3% moderate, 19.4% high) had elevated MPI scores.
- MPI scores correlated significantly with the Charlson index (P = .001) in ESRD patients.
- Dialysis patients exhibited more compromised MPI domains compared to controls.
Conclusions:
- MPI appears valuable for assessing the clinical status of older patients receiving renal replacement therapy (RRT).
- Further research is needed to explore MPI's utility in dialysis patients under 65.
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