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在4期CKD的老年退伍军人中,身体弹性发展轨迹
C Barrett Bowling1, Theodore S Z Berkowitz2, Brett T Burrows3
1Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham, North Carolina; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina; Center for the Study of Aging and Human Development (the Aging Center), Duke University, Durham, North Carolina; Department of Medicine, Duke University, Durham, North Carolina.
患有第四阶段慢性病 (CKD) 的老年人身体功能轨迹有显著差异. 了解功能储备和性是为这些患者提供个性化护理的关键.
科学领域:
- 老年学是一门学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 康复医学 康复医学 康复医学
背景情况:
- 功能障碍在患有慢性病 (CKD) 的老年人中很普遍.
- 在急性健康事件后,对该人口的功能储备和身体性有有限的了解.
- 患有第四阶段CKD的老年人在维持身体功能方面面临着独特的挑战.
研究的目的:
- 在老年退伍军人中识别身体功能轨迹的独特模式,这些退伍军人患有4期CKD.
- 描述急性健康事件发生前的功能储备和急性健康事件后的身体性.
- 探索这些功能轨迹的预测因素.
主要方法:
- 对272名70岁以上的退伍军人进行了前性队列研究,他们患有第四阶段的CKD (eGFR <30 mL/min/1.73m2).
- 在急性护理接触之前和之后,通过电话调查评估生活空间流动性.
- 用于识别功能轨迹类的一般生长混合模型.
主要成果:
- 确定了四种不同的物理功能轨迹:低储备/低弹性,高储备/高弹性,中等储备/中等弹性和高储备/低弹性.
- 在轨迹类之间观察到日常生活困难,症状负担,认知和抑郁症状的活动存在显著差异.
- 人口特征,eGFR和社会支持在轨迹类别之间没有显著差异.
结论:
- 身体功能轨迹在4期CKD的老年人中表现出相当大的变化.
- 将功能储备和弹性概念纳入临床实践可能有助于预测功能变化.
- 为优化这群人群的护理,建议定制治疗计划,包括储备和弹性.
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