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Kidney Week

Abstract: TH-PO666

Walking While Talking in Older Adults with CKD

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

  • Ho, Jim Q., Albert Einstein College of Medicine, Bronx, New York, United States
  • Verghese, Joe, Albert Einstein College of Medicine, Bronx, New York, United States
  • Abramowitz, Matthew K., Albert Einstein College of Medicine, Bronx, New York, United States
Background

Divided attention tasks predict falls in older adults. Adults with chronic kidney disease (CKD) have an increased risk of falling compared with people without CKD; however, it is unknown whether they have greater divided attention task interference.

Methods

Three hundred thirty nondisabled adults ≥65 years of age from the community participated in quantitative and clinical gait assessments, including a validated cognitive-motor dual task measure (Walking While Talking [WWT] Test). Multivariable linear regression that adjusted for demographics, body mass index, comorbidities, and medications was performed to examine the relationship between estimated glomerular filtration rate (eGFR) and WWT gait markers. CKD was defined as an eGFR <60 ml/min/1.73m2.

Results

One hundred thirty-four subjects (41%) had CKD. During WWT, participants with CKD had 5.8 cm/s (95% CI 0.6-11.0) slower gait speed, 2.4 cm (95% CI 0.05-4.7) shorter step length, and 2.0% (95% CI 0.2-3.8) greater time in the double support phase of the gait cycle compared with those without CKD. These abnormalities were related to severity of CKD: among participants with CKD, every 10 ml/min/1.73m2 lower eGFR was independently associated with 3.3 cm/s (95% CI 0.4-6.1) slower gait speed, 2.0 cm (95% CI 0.7-3.2) shorter step length, 4.0 cm (95% CI 1.5-6.4) shorter stride length, 1.2% (95% CI 0.7-1.8) less time in the swing phase, and 1.6% (95% CI 0.7-2.5) greater time in the double support phase. To better capture the multidimensional characteristics of gait, factor analysis was performed using the principal component method and produced 3 independent gait domains: Rhythm, Pace, and Variability. Every 10 ml/min/1.73m2 lower eGFR was associated with 0.2 standard deviation (95% CI 0.1-0.3) poorer performance in the Rhythm domain. There was no significant association between eGFR and the Pace or Variability domains.

Conclusion

CKD is associated with quantitative gait abnormalities while performing WWT tasks. Future studies should examine whether poorer performance on WWT tasks contributes to fall risk and is an early indicator of cognitive dysfunction in CKD.

Funding

  • NIDDK Support