Should Functional Impairment in Seniors With CKD Be Routinely Assessed?

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Conducting geriatric assessment in nephrology visit can ID functional impairment, guide care processes
Conducting geriatric assessment in nephrology visit can ID functional impairment, guide care processes

HealthDay News — Older adults with chronic kidney disease (CKD) have a considerable burden of functional impairment, according to research published online July 5 in the Journal of the American Geriatrics Society.

Rasheeda K. Hall, MD, MBA, from the Durham Veterans Affairs Medical Center in North Carolina, and colleagues implemented two innovative programs in the Veterans Health Administration that incorporate geriatric assessment into a nephrology visit. In one, a geriatrician used standardized geriatric assessment tools in a nephrology clinic among individuals with CKD aged 70 years and older (CGA-4-CKD). In the second, comprehensive appointments were used for individuals aged 75 years and older to conduct geriatric assessments and CKD care (Renal Silver). Data were included for 68 veterans with geriatric assessments through these programs.

The researchers found that 27.3% of the participants in CGA-4-CKD had difficulty with one or more activities of daily living (ADLs), history of falls, and cognitive impairment. In Renal Silver, 65.7, 28.6, and 51.6%, respectively, had ADL difficulty, falls, and cognitive impairment. In the CGA-4-CKD and Renal Silver programs, geriatric assessment guided care processes in 45.4 and 37.1%, respectively.

"Findings suggest there is a significant burden of functional impairment in older adults with CKD," the authors write. "Knowledge of this impairment is applicable to CKD management."

Abstract
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