Promoting functioning and well-being in older CKD patients: review of recent evidence.
Osteoporosis, falls, sleep difficulty, cognitive impairment, and depressed mood are major clinical concerns in the geriatric population that are physiologically and psychologically based and are often interrelated. All of these issues have implications for patients' daily functioning and quality of life (QOL). This review synthesizes recent evidence about these prominent issues in geriatric care and related implications for care of older patients with chronic kidney disease (CKD). Recent evidence about pre-dialysis and dialysis treatment strategies that may help to optimize management of older patients is also considered. Although elderly patients often report better psychosocial adjustment to dialysis than do younger patients, physical functioning and cognitive functioning losses challenge the QOL of many elderly persons. Early management of CKD and attention to anemia, consideration of the benefits of peritoneal dialysis compared with hemodialysis, and inclusion of some form of exercise or regular physical activity in routine care provide key opportunities to enhance the functioning and well-being of older patients.
Kutner
Nancy G
NG
Department of Rehabilitation Medicine, Emory University, CRM-1441 Clifton Rd. NE, Atlanta, GA, 30322, USA. nkutner@emory.edu
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications / Q000517:prevention & control; D003863:Depression / Q000150:complications / Q000517:prevention & control; D005081:Exercise Therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000523:psychology* / Q000628:therapy*; D010024:Osteoporosis / Q000150:complications / Q000517:prevention & control; D011788:Quality of Life; D006435:Renal Dialysis; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000150:complications / Q000517:prevention & control
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