Objective:
To investigate the status of
frailty and
activities of daily living (
ADL) in
maintenance hemodialysis (MHD)
patients, and to explore the effect of
frailty phenotype on
ADL.
Methods:
The
patients who underwent MHD in
Kidney Disease Center of the First Affiliated
Hospital from March 2019 to March 2020 were enrolled in this study. The demographic and laboratorial data were collected by
cross-sectional survey method. Fried
frailty phenotype scale and
ADL scale were used to evaluate the
frailty and
ADL, respectively. The differences of basic data and different
frailty phenotypes between the normal function group and the function decline group were compared in terms of
ADL, physical
self-
maintenance ability and instrumental
ADL ability. Pearson correlation
analysis was used to analyze the correlation between
frailty and
ADL, and binary
logistic regression analysis was used to analyze the influencing factors of
ADL.
Results:
A total of 676 MHD
patients were included in this study, including 434
males (64.2%) and 242
females (35.8%). The age was (59.2±19.4) years old, and the median
dialysis age was 59.0 (25.3, 110.0) months. There were 159
frailty patients (23.5%), 230 pre-
frailty patients (34.0%), and 287 non-
frailty patients (42.5%). The
ADL was decreased in 163
patients (24.1%), including 131
patients (19.4%) with decreased physical
self-
maintenance ability and 161
patients (23.8%) with decreased instrumental
ADL ability. Pearson correlation
analysis showed that the
frailty score was positively correlated with total
ADL score ( r=0.728, P<0.001), physical
self-
maintenance ability score ( r=0.669, P<0.001) and instrumental
ADL ability score ( r=0.729, P<0.001). Binary
logistic regression analysis results showed that older age and lower
physical activity,
fatigue, slowed steps and lower
grip strength in the
frailty phenotypes were the independent influencing factors of
ADL, physical
self-
maintenance ability and instrumental
ADL ability (all P<0.05).
Conclusions:
The
prevalence of
frailty is 23.5% in MHD
patients, and 24.1% of MHD
patients have decreased
ADL. Elder age and lower
physical activity,
fatigue, reduced step counts, and lower
grip strength in
frailty phenotypes are the independent influencing factors for poor
ADL, poor physical
self-
maintenance ability and poor instrumental
ADL ability.