Factors Affecting Frailty Scores in Elderly with Chronic Kidney Disease Undergoing Regular Haemodialysis at Haji Adam Malik Hospital

Abstract

Background: The prevalence of frailty in the elderly population is reported to be >60% in haemodialysis-dependent CKD patients. According to the Comprehensive Geriatric Assessment, several factors can influence frailty score. Identification of these risk factors is essential to improve and enhance the quality of care for CKD patients with frailty. Method: This is a cross sectional study done on elderly CKD patients undergoing routine haemodialysis at Haji Adam Malik Hospital Medan. Bivariate and multivariate data analysis was done to analyze correlations of factors towards frailty score. Results: From 62 samples, there was a correlation of age (p=0.019; R 0.298); nutritional factors (p<0.001; R -0.666); comorbidities (p<0.001; R 0.556); functional status (p<0.001; R -0.875); mental status (p<0.001; R -0.711); depression (p<0.001; R 0.557) with frailty and no correlation of gender with frailty (p=0.962). Multivariate analysis of all factors toward frailtyshowed significant p values in CCI, MMSE and ADL respectively 0.006; 0.004; 0.000 with R2 value of 80.1%. Conclusion: There were strong correlations on better geriatric nutritional, functional and mental status on a lower frailty score. Comorbidity severity and depression increased frailty scores moderately. Increasing age may increase frailty scores with a weak correlation magnitude. There was no significant correlation between gender and frailty. Multivariate analysis showed CCI, MMSE and ADL as the variables influencing frailty most. Keywords: Frailty, chronic kidney disease, haemodialysis.