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  • Title: Renal function and decline in functional capacity in older adults.
    Author: Chin HJ, Ahn SY, Ryu J, Kim S, Na KY, Kim KW, Chae DW, Kim CH, Kim KI.
    Journal: Age Ageing; 2014 Nov; 43(6):833-8. PubMed ID: 24908107.
    Abstract:
    BACKGROUND: longitudinal relationship between renal function, disability and mortality has not been evaluated. OBJECTIVE: we investigated the temporal association between renal function and disability, and aimed to identify the influence of disability on mortality according to renal function in a cohort of older Koreans. DESIGN/SETTING: Korean Longitudinal Study on Health and Aging is a prospective, population-based cohort. SUBJECTS: community-dwelling Koreans ≥65 years of age. MAIN OUTCOME MEASURES: Korean version of activities of daily living (ADL), Instrumental activities of daily living (IADL) and all-cause mortality. RESULTS: a total of 984 participants were followed for 5 years with a 70.9% participation rate. The participants were categorized into three groups according to their baseline estimated glomerular filtration rates (eGFRs) (Group I, ≥60; Group II, 45-59; and Group III, <45 ml/min/1.73 m(2)). Baseline eGFR was higher in participants who maintained functional status compared with participants who died or had disability at follow-up examination. The incidence of ADL/IADL decline was 13, 12.5 and 29.5% in participants who showed improvement, no change, and decline in renal function, respectively (P = 0.01). The hazard ratio for mortality in the subgroup with IADL disability was 1.87 (95% CI: 1.10-3.20, P = 0.022) in Group I, and 2.53 (95% CI: 1.57-4.09, P<0.001) in Groups II and III after adjustment. CONCLUSIONS: impaired renal function was related to disability and ADL/IADL decline. The effect of ADL/IADL disability on mortality was more prominent in participants with impaired eGFR.
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