| Routine use of an abbreviated 4-item scale to assess dependence in essential activities of daily living amongst elderly hemodialysis patients: a validation study. | |
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MedLine Citation:
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PMID: 23277193 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Poor functional status is associated with reduced survival and poor outcomes in older dialysis patients. The Geriatric Nephrology Advisory Group recommends routine evaluation of functional status on all older patients; however, assessments can be time consuming and burdensome to clinical care providers. The objective of this study was to validate an abbreviated 4-item self-report screening tool for use in elderly hemodialysis patients. METHODS: The functional dependence of community-dwelling hemodialysis patients, aged ≥65 years, was measured by trained evaluators. The accuracy of a 4-item self-report activities of daily living (ADL) score was compared against formal evaluation by the Barthel Index and the outcomes using agreement statistics and Cox regression analysis. RESULTS: The cohort included 167 patients with a mean age of 74.8 ± 5.9 years (57 % males). The 4-item scale correctly identified 83 % of the patients dependent in ≥1 ADL. Those incorrectly identified as independent on the abbreviated scale were uniformly unable to climb stairs without assistance. The sensitivity and specificity, and coefficient for agreement between the 4-item scale and the Barthel Index were 83.2, 100 and 0.78 %, respectively. The positive and negative predictive values of the 4-item scale were 100 and 76.9 %, respectively. Using the 4-item scale, the presence of severe disability was predictive of increased mortality (HR 12.5; 95 % CI 2.5-65.0; P = 0.03). CONCLUSIONS: The 4-item scale is a simple, valid screening test for disability which can be used in the elderly population on dialysis as a screening tool. Difficulties with stair climbing may be overlooked using this score. |
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Authors:
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Farhat Farrokhi; Sarbjit V Jassal |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-1 |
Journal Detail:
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Title: International urology and nephrology Volume: - ISSN: 1573-2584 ISO Abbreviation: Int Urol Nephrol Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0262521 Medline TA: Int Urol Nephrol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. |
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