Prevalence and risk factors of pre‐frailty and frailty in maintenance haemodialysis patients in China: A cross‐sectional Study

Abstract

AbstractAimsTo examine the prevalence and risk factors of pre‐frailty and frailty in maintenance haemodialysis patients in China.DesignA cross‐sectional study.MethodFrom January to July 2017, using the convenience sampling method, a total of 503 maintenance haemodialysis patients from six hospitals in Lianyungang, China, were recruited for this study. The participants' socio‐demographic, lifestyle factors and health information were assessed using a general information questionnaire. Frailty was evaluated based on the Fried frailty phenotype. Multi‐categorical logistic regression was performed to examine factors associated with pre‐frailty and frailty in this population, including age, sex, living alone, employment, educational level, body mass index, per capita monthly household income, smoking status, exercise status, primary diagnosis, dialysis age, frequency of dialysis, vascular access, congestive heart failure, other cardiac diseases, cerebrovascular disease, peripheral blood diseases, pain, albumin level and haemoglobin level.ResultsAmong the 503 participants with an average age of 53.02 years (standard deviation 14.99), 178 had pre‐frailty (35.3%) and were mostly young and middle‐aged. The prevalence of pre‐frailty among participants <60 years old was more than 40%. Regression analysis showed that lack of exercise, dialysis age ≤12 months, congestive heart failure and other cardiac diseases were positively associated with pre‐frailty. Two hundred and eighteen participants were frail (43.3%), most of whom were aged ≥60. The prevalence of frailty in participants ≥60 was 71.4%. Regression analysis showed that advanced age, being female, obesity, low per capita monthly household income, lack of exercise, diabetes as the primary disease, dialysis age ≤12 months, congestive heart failure, other cardiac diseases, pain and low albumin level, were positively associated with frailty. In addition, more than half of the participants hardly exercised (64.6%), while lack of exercise was a risk factor for pre‐frailty and frailty. A third of the participants had pain (33.4%), while pain was an independent risk factor for pre‐frailty and frailty in these participants.ConclusionPre‐frailty and frailty are common in patients with maintenance haemodialysis. Most of the elderly maintenance haemodialysis patients are frail, and most of the young and middle‐aged patients are pre‐frail. Clinicians should actively screen the pre‐frailty and frailty among patients with maintenance haemodialysis, especially those with dialysis age ≤12 months. Many factors affect pre‐frailty and frailty in this population. Tailored intervention measures should be designed and implemented based on these factors, giving priority to exercise guidance and pain management for patients to help them prevent or reverse pre‐frailty and frailty.