1. ¹Division of Geriatric Medicine, Department of Medicine, Providence Health Care, University of British Columbia, Vancouver, British Columbia, Canada
2. ²Division of Nephrology, University Health Network, Toronto, Canada
3. ³Department of Medicine, University of Toronto, Toronto, Ontario, Canada

Correspondence: WL Cook, Division of Geriatric Medicine, Floor 9B—9426 St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia, Canada V5Z 1Y6. E-mail: wcook@providencehealth.bc.ca

Received 9 March 2007; Revised 12 December 2007; Accepted 18 December 2007; Published online 19 March 2008.

Abstract

As the dialysis population ages, their limitations in performing daily activities affect the well-being of the patients as well as increase the burden on caregivers and the use of health services. In this cross-sectional study, we measured the proportion of patients 65 years and older undergoing chronic outpatient hemodialysis who needed help with day-to-day activities and identified the clinical characteristics of this population at most risk. Their dependence in performance of basic self-care tasks and instrumental activities such as driving were measured by the Barthel and Lawton Scales. Associations between disability in four basic activities to age, gender, education, multiple prescription drug needs, diabetes, cognition, depressive symptoms, and physical performance were examined using logistic regression. Of the 162 mostly male participants averaging 75 years old, eight had no disability, 69 had only instrumental dependence, and 85 had combined disability. Multiple prescription drug needs, poor timing in 'up-and-go' mobility performance, and education level were associated with basic dependency. Our study shows that the disability in self-care is common among older patients on hemodialysis. Strategies are needed to routinely identify those older dialysis patients at risk of functional impairment and to limit their disabilities.