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Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study.

Publication ,  Journal Article
McAdams-DeMarco, MA; Suresh, S; Law, A; Salter, ML; Gimenez, LF; Jaar, BG; Walston, JD; Segev, DL
Published in: BMC Nephrol
October 16, 2013

BACKGROUND: Patients undergoing hemodialysis are at high risk of falls, with subsequent complications including fractures, loss of independence, hospitalization, and institutionalization. Factors associated with falls are poorly understood in this population. We hypothesized that insights derived from studies of the elderly might apply to adults of all ages undergoing hemodialysis; we focused on frailty, a phenotype of physiological decline strongly associated with falls in the elderly. METHODS: In this prospective, longitudinal study of 95 patients undergoing hemodialysis (1/2009-3/2010), the association of frailty with future falls was explored using adjusted Poisson regression. Frailty was classified using the criteria established by Fried et al., as a combination of five components: shrinking, weakness, exhaustion, low activity, and slowed walking speed. RESULTS: Over a median 6.7-month period of longitudinal follow-up, 28.3% of study participants (25.9% of those under 65, 29.3% of those 65 and older) experienced a fall. After adjusting for age, sex, race, comorbidity, disability, number of medications, marital status, and education, frailty independently predicted a 3.09-fold (95% CI: 1.38-6.90, P=0.006) higher number of falls. This relationship between frailty and falls did not differ for younger and older adults (P=0.57). CONCLUSIONS: Frailty, a validated construct in the elderly, was a strong and independent predictor of falls in adults undergoing hemodialysis, regardless of age. Our results may aid in identifying frail hemodialysis patients who could be targeted for multidimensional fall prevention strategies.

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Published In

BMC Nephrol

DOI

EISSN

1471-2369

Publication Date

October 16, 2013

Volume

14

Start / End Page

224

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Survival Rate
  • Risk Factors
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • Prospective Studies
  • Muscle Weakness
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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McAdams-DeMarco, M. A., Suresh, S., Law, A., Salter, M. L., Gimenez, L. F., Jaar, B. G., … Segev, D. L. (2013). Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study. BMC Nephrol, 14, 224. https://doi.org/10.1186/1471-2369-14-224
McAdams-DeMarco, Mara A., Sunitha Suresh, Andrew Law, Megan L. Salter, Luis F. Gimenez, Bernard G. Jaar, Jeremy D. Walston, and Dorry L. Segev. “Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study.BMC Nephrol 14 (October 16, 2013): 224. https://doi.org/10.1186/1471-2369-14-224.
McAdams-DeMarco MA, Suresh S, Law A, Salter ML, Gimenez LF, Jaar BG, et al. Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study. BMC Nephrol. 2013 Oct 16;14:224.
McAdams-DeMarco, Mara A., et al. “Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study.BMC Nephrol, vol. 14, Oct. 2013, p. 224. Pubmed, doi:10.1186/1471-2369-14-224.
McAdams-DeMarco MA, Suresh S, Law A, Salter ML, Gimenez LF, Jaar BG, Walston JD, Segev DL. Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study. BMC Nephrol. 2013 Oct 16;14:224.
Journal cover image

Published In

BMC Nephrol

DOI

EISSN

1471-2369

Publication Date

October 16, 2013

Volume

14

Start / End Page

224

Location

England

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Survival Rate
  • Risk Factors
  • Renal Insufficiency, Chronic
  • Renal Dialysis
  • Prospective Studies
  • Muscle Weakness
  • Middle Aged
  • Male