Geriatric syndromes and health-related quality of life in older adults with chronic kidney disease: ancillary analysis of the award randomized clinical trial

Authors: LIU, CHRISTINE - Stanford University; MIAO, SHIYUAN - Tufts Medical Center; GIFFUNI, JAMIE - Veterans Affairs Maryland Healthcare System; KATZEL, LESLIE - Veterans Affairs Maryland Healthcare System; FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; SELINGER, STEPHEN - University Of Maryland; WEINER, DANIEL - Tufts Medical Center

Submitted to: Kidney360
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/21/2023
Publication Date: 4/1/2023
Citation: Liu, C.K., Miao, S., Giffuni, J., Katzel, L., Fielding, R.A., Selinger, S.I., Weiner, D.E. 2023. Geriatric syndromes and health-related quality of life in older adults with chronic kidney disease: Ancillary analysis of the award randomized clinical trial. Kidney360. https://doi.org/10.34067/KID.0000000000000078.
DOI: https://doi.org/10.34067/KID.0000000000000078

Interpretive Summary: Common medical conditions of older adults often referred to as "geriatric syndromes" include poor cognition, loss of appetite, dizziness, fatigue, and chronic pain. In this study, we examined whether "geriatric syndromes" were associated with reduced quality of life in older adults with chronic kidney disease (CKD). In 99 study participants with CKD, we found that people with a greater number of geriatric syndromes showed lower measurers of quality of life. These results suggest that addressing common geriatric syndromes may improve quality of life in adults living with chronic kidney disease.

Technical Abstract: Background: Geriatric syndromes, which are multi-factorial conditions common in older adults, predict health-related quality of life (HRQOL). Although chronic kidney disease (CKD) is associated with lower HRQOL, whether geriatric syndromes contribute to HRQOL in CKD is unknown. Our objective was to compare associations of geriatric syndromes and medical conditions with HRQOL in older adults with CKD. Methods: This was a secondary analysis of a randomized controlled clinical trial evaluating a 12-month exercise intervention in persons >=55 years with CKD Stage 3b-4. Participants were assessed for baseline geriatric syndromes (cognitive impairment, poor appetite, dizziness, fatigue, and chronic pain), and medical conditions (diabetes, hypertension, coronary artery disease, cancer, or chronic obstructive pulmonary disease). Participants' HRQOL was assessed with the Short Form Health Survey-36 (SF-36), EuroQol 5 Dimensions-5 Level, and the EuroQol Visual Analogue Scale. We examined the cross-sectional and longitudinal associations of geriatric syndromes and medical conditions with HRQOL using multiple linear regression. Results: Among 99 participants, the mean age was 68.0 years, 25% were female, and 62% were Black. Participants had a baseline mean of 2.0 geriatric syndromes and 2.1 medical conditions; 49% had >= two geriatric syndromes and >= two medical conditions concurrently. Sixty-seven participants (68%) underwent 12-month assessments. In models using geriatric syndromes and medical conditions as concurrent exposures, the number of geriatric syndromes was cross-sectionally associated with SF-36 scores for general health (B = -0.385), role limitations due to physical health (B=-0.374), physical functioning (B= -0.300, all p < 0.05). The number of medical conditions was only associated with SF-36 score for role limitations due to physical health (B = -0.205). Conclusions: In older adults with CKD Stage 3b-4, geriatric syndromes are common and are associated with lower HRQOL. Addressing geriatric conditions is a potential approach to improve HRQOL for older adults with CKD.