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Functional Decline Seen in Many Older Adults Initiating Dialysis

Prevalence of high caregiver burden increased after initiation of dialysis

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FRIDAY, June 28, 2019 (HealthDay News) -- For older adults initiating dialysis, many experience a decline in functional status after six months, and the prevalence of high caregiver burden increases, according to a study published online June 27 in the Clinical Journal of the American Society of Nephrology.

Namiko A. Goto, M.D., from the University Medical Center Utrecht in the Netherlands, and colleagues examined correlations among dialysis initiation in an elderly population, functional status, and caregiver burden. Data were included for 187 participants aged ≥65 years with end-stage kidney disease who underwent a geriatric assessment and a frailty screening at the time of dialysis initiation.

The researchers found that 79 percent of participants were care-dependent in functional status at the start of dialysis. After six months, 40 percent of participants experienced a decline in functional status, 34 percent remained stable, 18 percent improved, and 8 percent died. There was a significant increase in the prevalence of high caregiver burden from 23 percent to 38 percent. Age (odds ratio, 1.05 per year older at baseline; 95 percent confidence interval [CI], 1.00 to 1.10) and a high Groningen Frailty Indicator score compared with a low score (odds ratio, 1.97; 95 percent CI, 1.05 to 3.68) correlated with functional decline/death in multivariable analysis.

"Further research should focus on improving the identification of patients at risk for functional decline and interventions that could maintain functional status," the authors write.

The study was partially funded by AstraZeneca.

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