Evaluation Of Physical Function Using Self-reported Vs Objective Measures In Older Adults Receiving Hemodialysis

Evaluation of Physical Function Using Self-Reported Vs Objectives Measures in Older Adults Receiving Hemodialysis Patients with chronic kidney disease (CKD) often experience diminished physical function, resulting in reduced endurance, increased dependence, and overall reduced quality of life. To this end, the use of simple and practical assessment tools is essential to accurately gauge and address the loss of physical function. PURPOSE: This study aimed to determine the correlation between self-reported and objective measures of physical function. METHODS: This is a single site cross-sectional observational study at patient’s home, where the criteria for recruitment was older adults ≥60 years and receiving outpatient Hemodialysis (HD). Self-reported physical activity levels were assessed using the standardized Ambulatory Measure in Post-Acute Care (AMPAC) scale, while objective physical performance was measured using the Short Physical Performance Battery (SPPB). The AMPAC scale is comprised of three domains: Basic Mobility, daily activities, and Applied Cognitive activities. The SPPB is comprised of testing balance (side by side, semi-tandem, and tandem standing), lower body function (time taken for 5 sit-to-stand movements), and gait speed (9-foot walking distance). RESULTS: A total of 54 participants (57% males) with a mean ± SD age of 76.2 ± 10.0 years (range: 61-100) were included in the study. The mean ± SD score of SPPB was 5.20 ± 2.37 points (range: 1-10), while the mean ± SD score of AMPAC was 54.0 ± 9.47 (range: 29-80). Bivariate correlational analysis revealed a significant association between overall AMPAC scores and SPPB scores (r = 0.73, p-value <0.0001). CONCLUSION: Self-reported assessments of physical function using the AMPAC scale align well with objective physical performance measures in HD patients. This suggests that the AMPAC scale may serve as a valuable tool for gauging overall physical functional status in home-bound individuals with complex medical conditions, such as CKD patients on HD, for whom direct physical performance measurements may be challenging due to various limitations.