Abstract
Background: In the near future in Japan, chronic dialysis patients will likely face a situation where the aging and the lengthening of hemodialysis treatment periods will adversely affect the mobility-related activities of daily living (MR-ADL). The aim of this study was to investigate chronological change in MR-ADL among chronic dialysis patients in need of long-term care and the effect of admission to long-term care facilities on their MR-ADL. Methods: Data were analyzed from a long-term care eligibility assessment survey conducted in late March 2009 of 1000 individuals residing in Niigata City, Japan who were approved to receive long-term care. Then data from those individuals who had undergone the assessment survey ≥4 times over a period of ≥4 years were statistically evaluated. To reveal change in MR-ADL, this study performed a three-way analysis of variance with mean survey scores from assessment categories 2 - 5 containing questions related to MR-ADL as the independent variable and the number of eligibility assessment surveys (within-subjects factor), facility admission, and dialysis therapy (between-subjects factors) as dependent variables. Results: We observed the effect of facility admission in individuals aged >70 years for categories 2 - 5, and observed the effect of the number of assessment surveys taken only in women ≥80 years for categories 2 and 5. Regarding the effect of dialysis therapy, female dialysis patients aged ≥80 years and in need of long-term care scored significantly higher on survey items for transferring, grooming, toileting, eating, and instrumental activities of daily living, all of which are indicators of a moderate decline in ADL. Conclusions: Because dialysis is often initiated in women aged around 80 years, ADL in this group of individuals can be improved by the initiation and proper provision of dialysis.
Highlights
In Japan, the mean age of chronic dialysis patients in late 2011 was 66.5 years, an increase of 4.9 years over 2001 figures
We observed the main effect of dialysis among women aged ≥80 years for categories 2, 4, and 5. This might indicate that ADL in these female dialysis patients aged around 80 improved with dialysis therapy. These results suggest that it is important for dialysis patients in need of long-term care to receive proper dialysis therapy and prevent symptoms that are associated with a moderate decline in ADL
We used scores from categories 2 - 5 of the long-term care eligibility assessment survey, categories which evaluate the quality of mobility-related activities of daily living (MR-ADL), and calculated scores according to sex and age
Summary
In Japan, the mean age of chronic dialysis patients in late 2011 was 66.5 years, an increase of 4.9 years over 2001 figures. In the near future in Japan, chronic dialysis patients will likely face a situation where the aging and the lengthening of hemodialysis treatment periods will adversely affect the mobility-related activities of daily living (MR-ADL). Methods: Data were analyzed from a longterm care eligibility assessment survey conducted in late March 2009 of 1000 individuals residing in Niigata City, Japan who were approved to receive long-term care. Data from those individuals who had undergone the assessment survey ≥4 times over a period of ≥4 years were statistically evaluated.
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