QUALITY OF LIFE AND PHYSICAL ACTIVITY OF ELDERLY PATIENTS WITH CARDIOVASCULAR DISEASES AND CHRONIC KIDNEY DISEASE

Abstract

Objective: Chronic kidney disease (CKD) is an unfavorable prognostic factor in patients with cardiovascular diseases (CVD). Physical activity is associated with a better prognosis and improvement of the functional status of patients. The aim of this study was to investigate quality of life and physical activity of elderly patients with CVD and CKD. Design and method: 214 elderly patients with stable cardiovascular diseases (106 males, mean age 69.5 ± 7.6 years) were studied. Arterial hypertension had 201 (93.9%)patients, coronary artery disease - 198 (92.5%), 150 (70%) - chronic heart failure, 57 (26.6%) - diabetes mellitus. Arterial hypertension was diagnosed according to the ESC guidelines (2018). Components of physical activity were assessed through questionnaires, interviews and International Questionnaire on Physical Activity (IPAQ). The quality of life of patients was estimated using EQ-5D-5L (Russian, 2009 EuroQol Group) and Visual analog scale. Frailty syndrome and personality profile (PHQ-9) were appreciated. Results: CKD with glomerular filtration rate (GFR) less than 60 ml/min/1.73 m2(CKD-EPI, 2011) was diagnosed in 144 (67.3%) patients. The frequency of physical activity in elderly patients with CVD did not differ depending on the presence of CKD (p > 0.05). Despite the rather high awareness of the benefits of physical activity (75%), adherence to the recommendations in elderly patients with CVD and CKD was significantly lower (63.2%) (X2 = 4.7; p = 0.03). Hypodynamia was observed in 54 (37.5%) elderly patients with CKD. The main type of physical activity for elderly patients with CKD was walking. Patients with CKD and frailty syndrome had lower indicators of physical activity (IPAQ) compared with patients without frailty syndrome: 14.5 (7.5;24) and 19 (12;26) points, resp., p = 0.03. Patients with CKD and hypodynamia had a higher level of depressive reactions (PHQ-9) (11 (8;15) and 9 (6;11) scores, resp., p = 0.03.), lower visual analogue scale scores (60 (45; 70) and 55 (50; 70) scores, p = 0.002) and the integral indicator of QoL (0.37 (0.27; 0.53) and 0.56 (0.53) .33; 0.68), p = 0.01)compared with patients without hypodynamia. Conclusions: Hypodynamia was observed in 37.5% elderly patients with CVD and CKD and leads to depressive reactions and a decrease in the quality of life.