ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2024
Trajectories of Physical Resilience Among Older Veterans With Stage 4 CKD.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 8 citations in OpenAlex.
- Influential factors of benefit finding in hemodialysis patients: a qualitative study using the social-ecological model.BMC nephrology · 2026Article
- Psychological Resilience and Physical Function in Veterans With Chronic Kidney Disease: A Brief Report.Journal of the American Geriatrics Society · 2025Article
- Defining the concept of physical resilience and quantifying recovery during standing balance in middle-aged and older adults.Scientific reports · 2025Article
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10 authors at 3 institutions in 1 country.
Funding
Abstract
RATIONALE &
objectiveAlthough functional impairment is common among older adults with chronic kidney disease (CKD), functional reserve before an acute health event and physical resilience after the event have not been characterized in this population. The purpose of this study was to identify distinct patterns of physical function before and after an acute health event among older veterans with stage 4 CKD. STUDY
designProspective cohort study. SETTING &
participantsNational sample of veterans≥70 years of age with an estimated glomerular filtration rate (eGFR) of<30mL/min/1.73m PREDICTORS: Demographic characteristics, eGFR, basic and instrumental activities of daily living (ADL/IADL) difficulty, symptom burden, cognition, depressive symptoms, social support. OUTCOME: Function measured using the life-space mobility assessment obtained by telephone survey before and after an acute care encounter. ANALYTICAL APPROACH: General growth mixture models to identify classes of functional trajectories. Calculation of percentages for demographic characteristics and means for eGFR, ADL/IADL difficulty, symptom burden, cognition, depressive symptoms, and social support by trajectory class.
resultsFour trajectory classes were identified and characterized by different levels of life-space mobility before (reserve) and change in life-space mobility after (resilience) an acute care encounter: (1) low reserve, low resilience (n=91), (2) high reserve, high resilience (n=23), (3) moderate reserve, moderate resilience (n=89), and (4) high reserve, low resilience (n=69). Mean levels of ADL/IADL difficulty, symptom burden, cognition, and depressive symptoms, but not demographic characteristics, eGFR, or social support, differed by trajectory class. LIMITATIONS: Veteran cohort was primarily male.
conclusionsAmong older adults with stage 4 CKD, physical function trajectories before and after an acute health event vary. Integrating reserve and resilience into care for this population may be useful for anticipating changes in function and developing tailored treatment plans.
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