Relationship Between Frailty, as Assessed Using the Kihon Checklist, and Falls in Hemodialysis Patients: A...

Hemodialysis (HD) patients are at a high risk of frailty, falls, and fractures. The Kihon checklist (KCL) consists of physical function, cognitive function, oral function, nutritional status, depressed mood, activities of daily living, and social participation. This study aimed to clarify the association between falls in HD patients and frailty as assessed using the KCL, as well as scores and each domain.

A multicenter prospective cohort study was conducted across 9 facilities. Frailty was assessed using the KCL. Falls were then monitored for 1 year. Participants were classified into 3 groups based on their KCL scores: robust, prefrailty, and frailty. In the logistic regression analysis, the dependent variables were falls, severe falls, or fractures, whereas the independent variables were group classification, KCL score, or each domain.

A total of 403 HD patients (70.0 [60.0-76.0] years, 170 [42.1%] women) were analyzed. During the 1-year follow-up period, 117 (29.0%) patients experienced falls. Prefrailty (odds ratio (OR) 3.00, 95% confidence interval (CI) 1.17-7.71, P < .001) and frailty (OR 6.79, 95% CI 2.69-17.16, P < .001) were independently associated with falls compared with robust patients. Additionally, the KCL score was associated with severe falls (OR 1.15, 95% CI 1.06-1.25, P = .001) and fracture (OR 1.13, 95% CI 1.01-1.28, P = .04). By KCL domain, physical function (OR 3.46, 95% CI 2.06-5.83, P < .001) and cognitive function (OR 1.74, 95% CI 1.09-2.77, P = .02) were independently associated with falls.

The KCL may be a useful screening tool for estimating fall and fracture risk in this population.