Abstract: TH-PO672
Physical Activity and Fatigue as Measures of Day-to-Day Resilience in Older Hemodialysis Patients
Session Information
- Geriatric Nephrology
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1100 Geriatric Nephrology
Authors
- Hall, Rasheeda K., Duke University, Durham, North Carolina, United States
- Rutledge, Jeanette, Duke University, Durham, North Carolina, United States
- Sloane, Richard, Duke University, Durham, North Carolina, United States
- Green, Ciara T., Duke University, Durham, North Carolina, United States
- Pieper, Carl F., Duke University, Durham, North Carolina, United States
- Colon-emeric, Cathleen, Duke University, Durham, North Carolina, United States
- Hall, Katherine, Duke University, Durham, North Carolina, United States
Background
Hemodialysis (HD) is a physiological stressor requiring day-to-day resilience, or an innate ability to recover after a HD session. Our objective was to assess whether physical activity (PA) and self-reported fatigue are representative measures of day-to-day resilience.
Methods
We recruited ambulatory adults aged ≥55 years receiving HD who did not have advanced dementia, hospice care, or long-term care residence. Participants completed PA monitoring via wrist actigraphy for 14 days with concurrent fatigue assessment: “On a scale from 0-10, rate your fatigue, with 10 being fatigue as bad as you can imagine”. Fatigue was assessed within 4 hours after HD and in the morning and afternoon on non-HD days. Prior to a HD session, we assessed physical function via the short physical performance battery (SPPB) (range, 0-12) and grip strength. We measured correlation between PA (steps) and concurrent fatigue in 4-hour intervals. PA variability, a measure of PA change when not at HD, was calculated from the standard deviation of the difference (absolute value) in steps of each 4-hour interval. We measured correlation between PA variability and physical function.
Results
Among 29 participants, mean±SD age was 70.6±4.8 years, 55.2% (n=16) male, 72.4% (n=21) black race, and mean years of dialysis was 3.9±3.6. Mean SPPB, gait speed (from SPPB), and grip strength were 6.3±3.2 (<10 indicates functional impairment), 0.72±0.3 m/s, and 57.8±16.7 kg, respectively. Mean PA monitoring time was 12.9±5.7 days. Mean daily steps was lower on HD days than non-HD days (967.1±557.0 vs. 1158.6±816.4) (p=0.004). Mean fatigue scores on HD days and non-HD days were similar (4.1±2.7 vs. 3.5±2.5) (p=0.06). The correlation between 4-hour post-dialysis PA and fatigue was -0.19 (n=102, p=0.06). The correlation between PA and fatigue at all other 4-hour intervals was -0.17 (n=210, p=0.01). Mean PA variability was 140.0±67.3 steps and its correlation with SPPB, gait speed, and grip strength was 0.47 (n=28, p=0.01), 0.52 (n=27, p=0.01), and 0.71 (n=27, p<0.0001), respectively.
Conclusion
In this sample of older HD patients, higher PA and greater PA variability were associated with lower fatigue and better physical function, respectively. PA monitoring and interval fatigue may be useful measures for interventions targeting resilience.
Funding
- Other NIH Support