Quality of life and cognitive and functional performance of octogenarians and nonagenarians undergoing hemodialysis.
OBJECTIVE
To evaluate the quality of life, cognitive and functional capacity of older adult patients undergoing hemodialysis who are 80 years of age or older and compare them to older adults without chronic kidney disease (CKD) treated at a geriatrics outpatient clinic.


METHOD
First, 103 older adult patients undergoing hemodialysis and 103 older adults without CKD matched by gender and age were evaluated. Cognitive aspects as evaluated by the mini mental state examination, the Boston Naming Test and verbal fluency were analyzed; comorbidities according to the Charlson's comorbidity index; social support through the Medical Outcomes Study scale; functional ability through the chair sit-to-stand and gait speed tests, as well as the basic activities of daily living (BADL) and instrumental activities of daily living (IADL) and quality of life according to the Kidney Disease Quality of Life Short Form (KDQOL SF-36) questionnaires.


RESULTS
The hemodialysis group had a higher rate of comorbidities (7.8 ± 2.4 vs. 5.8 ± 2.3, p < 0.001). In the multiple logistic regression analysis, the group undergoing hemodialysis presented a ninefold greater chance of dependence for IADL than controls, a 4.3 and 3.2 times greater chances for inadequacy on the gait speed and chair sit-to-stand tests, respectively, as well as a 4.4-fold higher risk of cognitive decline on the verbal fluency test.


CONCLUSION
Long-lived patients undergoing hemodialysis presented worse quality of life and functional and cognitive performance compared to long-term patients attended at the outpatient clinic, indicating that preventive and protective measures should be considered and implemented.
['Portela|Odete Teresinha|OT|', 'Belasco|Angélica Gonçalves Silva|AGS|', 'Casarin|Bruno Felipe|BF|', 'Lana|Letice Dalla|LD|http://orcid.org/0000-0002-9624-8152', 'Nascimento|Ildelina Pereira|IP|', 'Barbosa|Dulce Aparecida|DA|', 'Martini|Adriana Ferreira|AF|', 'Sesso|Ricardo|R|']
D000203:Activities of Daily Living D000367:Age Factors D000369:Aged, 80 and over D003071:Cognition D003430:Cross-Sectional Studies D005260:Female D006801:Humans D007676:Kidney Failure, Chronic D008297:Male D000076604:Physical Functional Performance D011788:Quality of Life D006435:Renal Dialysis D012944:Social Support D011795:Surveys and Questionnaires
Quality of life Older adults Chronic kidney disease Dialysis Mental assessment Physical evaluation Renal replacement therapy