Difficulty in activities of daily living and falls in patients undergoing hemodialysis: A cross-sectional study with nondialysis controls

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Abstract

Introduction: Impaired activities of daily living (ADL) and falls are important issues in hemodialysis patients. So far, information is limited regarding self-reported difficulty with activities of daily living in hemodialysis patients. Then, we compared the degree of activities of daily living difficulty and the prevalence of fallers between hemodialysis patients and a non dialyzed control group. Also, the possible association between ADL difficulty and falls was examined.This was a single center, cross-sectional study including two groups of outpatients aged 50 years or older; 209 prevalent hemodialysis patients, and 139 nonrenal patients with diabetes mellitus, hypertension, and/or dyslipidemia (control group). activities of daily living difficulty score was evaluated by a 48-item questionnaire including six subscales of locomotion, eating, toileting, dressing, bathing, and grooming. Experience of falls in the previous year period was examined by a questionnaire.

The two groups did not differ significantly in age or sex. The hemodialysis group had a higher median (interquartile range) total score of activities of daily living difficulty than the control group and a higher prevalence of fallers. In multivariable-adjusted linear regression analyses, history of falls was independently associated with a higher score of activities of daily living difficulty for total or each of the six subscales.

Conclusion: The hemodialysis patients had more difficulties with daily activities,such as locomotion, eating, toileting, dressing, bathing, and grooming, and a higher prevalence of fallers than the control group. Self-reported daily activity difficulty and falls were closely linked regardless of the patient group.

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