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Functional Disability in Older Adults Maintained on Peritoneal Dialysis Therapy
Ozkan Ulutas1, Janine Farragher2, Ernest Chiu2
1Division of Nephrology, University Health Network, Toronto Division of Nephrology, Faculty of Medicine, Inonu University, Malatya, Turkey.
Summary
Older adults on peritoneal dialysis (PD) often need help with daily activities. Most PD patients experienced functional decline, highlighting the need for integrated geriatric and renal care.
Area of Science:
- Geriatric Medicine
- Nephrology
- Renal Dialysis
Background:
- Older in-center hemodialysis patients exhibit significant functional disability.
- Limited data exists on functional status of older patients on home peritoneal dialysis (PD).
- Home dialysis patients are expected to be more involved in self-care, necessitating understanding of their functional independence.
Purpose of the Study:
- To assess the prevalence of functional dependence in basic self-care (ADL) and instrumental activities of daily living (IADL) among older PD patients.
- To evaluate physical performance and cognitive function in this population.
Main Methods:
- Cross-sectional study of 74 older (≥65 years) outpatient PD patients (excluding nursing home residents).
- Assessment of functional dependence using Barthel and Lawton Scales for ADL and IADL.
- Measurement of physical performance (Timed Up-and-Go, chair stands) and cognitive function (Folstein Mini-Mental Score).
Main Results:
- The majority of PD patients (64% ADL, 89% IADL) required assistance with daily activities.
- A significant proportion demonstrated impaired cognitive function (36% MMSE), mobility (51% TUG), and lower body strength (69% chair stands).
- Only 11% of patients were fully independent in both ADL and IADL.
Conclusions:
- Older patients on PD frequently experience impaired physical and functional performance.
- The findings underscore the need for specialized care models, such as collaborative geriatric-renal programs, for dialysis patients.
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