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Am J Kidney Dis. 2014 Mar;63(3):429-36. doi: 10.1053/j.ajkd.2013.07.022. Epub 2013 Sep 26.

Community mobility among older adults with reduced kidney function: a study of life-space.

Author information

1
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, AL; Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address: cbbowli@emory.edu.
2
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
3
Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
4
Division of Nephrology, Department of Medicine, University of Alabama at Birmingham and Department of Veterans Affairs Medical Center, Birmingham, AL.
5
Department of Rehabilitation Medicine, Emory University, Atlanta, GA.
6
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, AL; Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.

Abstract

BACKGROUND:

Life-Space Assessment captures community mobility and social participation and quantifies the distance, frequency, and independence obtained as an older adult moves through his or her environment. Reduced estimated glomerular filtration rate (eGFR) is associated with decline in activities of daily living among older adults, but less is known about the association of eGFR with restrictions in mobility.

STUDY DESIGN:

Prospective observational cohort study.

SETTING & PARTICIPANTS:

Community-dwelling Medicare beneficiaries from the University of Alabama at Birmingham Study of Aging who had serum creatinine measured during a baseline in-home study visit and completed at least one telephone follow-up (N = 390).

PREDICTOR:

eGFR ≥ 60, 45-59, and <45 mL/min/1.73 m(2).

OUTCOME:

Life-space mobility trajectory.

MEASUREMENTS:

Life-space mobility was evaluated by telephone every 6 months for up to 4.5 years using the previously validated Life-Space Assessment. Scores using this tool range from 0-120 (higher scores indicate greater mobility).

RESULTS:

Mean age of the 390 participants was 77.6 ± 5.8 (SD) years, 41% were African American, 50.5% were women; 30.0% had eGFR of 45-59 mL/min/1.73 m(2), and 20.2% had eGFR < 45 mL/min/1.73 m(2). Age-, race-, and sex-adjusted mean baseline life-space mobility scores were 64.8(95% CI, 62.0-67.6), 63.8 (95% CI, 60.3-67.4), and 58.3 (95% CI, 53.8-62.7) among those with eGFR categories ≥ 60, 45-59, and <45 mL/min/1.73 m(2), respectively. Compared with those with eGFRs ≥ 60 mL/min/1.73 m(2), a more rapid decline in life-space mobility was found among those with eGFRs < 45 mL/min/1.73 m(2), though this did not reach statistical significance (P=0.06); a similar effect was not seen among those with eGFRs of 45-59 mL/min/1.73 m(2) (P=0.3).

LIMITATIONS:

Urinary albumin or longitudinal measures of eGFR were not available.

CONCLUSIONS:

eGFR < 45 mL/min/1.73 m(2) was associated with a trend toward a more rapid decline in life-space mobility among community-dwelling older adults. Findings should be confirmed in a larger population.

KEYWORDS:

Chronic kidney disease; elderly; life-space mobility

PMID:
24074823
PMCID:
PMC3943884
DOI:
10.1053/j.ajkd.2013.07.022
[Indexed for MEDLINE]
Free PMC Article

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