Physical and psychological burden of chronic kidney disease among older adults.
BACKGROUND
The purpose of the study is to determine if functional status and quality of life (QoL) vary with glomerular filtration rate (GFR) among older adults.


METHODS
We studied adults aged 45 years and older participating in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. Data included demographic and health information, serum creatinine and hemoglobin, the 4-item Center for Epidemiologic Studies Depression Scale (CES-D-4), the 4-item Cohen's Perceived Stress Scale (PSS-4), reported health status and inactivity and the Medical Outcomes Study Short Form-12 (SF-12) QoL scores.


RESULTS
CKD (GFR <60 ml/min/1.73 m(2)) was present in 11.6% of the subjects. As GFR declined, the SF-12 physical component score, adjusted for other participant attributes, declined from 38.9 to 35.9 (p = 0.0001). After adjustment for other risk factors, poorer personal health scores (p < 0.0001) and decreased physical activity (p < 0.0001) were reported as GFR declined. In contrast, after adjusting for other participant characteristics, depression scores and stress scores and the mental component score of the SF-12 were not associated with kidney function.


CONCLUSIONS
Older individuals with CKD in the US population experience an increased prevalence of impaired QoL that cannot be fully explained by other individual characteristics.
McClellan
William M
WM
Departments of Medicine and Epidemiology, Emory University, Atlanta, Ga., USA. wmcclel@sph.emory.edu
Abramson
Jerome
J
Newsome
Britt
B
Temple
Ella
E
Wadley
Virginia G
VG
Audhya
Paul
P
McClure
Leslie A
LA
Howard
Virginia J
VJ
Warnock
David G
DG
Kimmel
Paul
P
D000368:Aged; D002908:Chronic Disease; D017281:Cost of Illness; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000523:psychology*; D008297:Male