Fragility assessment in a dialysis center. Are patients with diabetes more fragile than others?

Abstract

Introduction: The increase in the inclusion of elderly people in hemodialysis programs is connected to a rise in the prevalence of their frailty, considered as well as a prediction of disability and often associated with adverse health events. Given its reversible nature, screening is essential to improve clinical practice. Objective: To assess the frailty index and the patient functional status in our hemodialysis unit, as well as analyze the differences between diabetics and non-diabetics. Material and Method: Observational cross-sectional study. Frailty was measured using the Fried phenotype and functional assessment using the Barthel, Lawton, Downton, and Short Physical Performance Battery scales. Comorbidity and fall risk were evaluated with the Charlson and Downton scales, respectively. Diabetic and non-diabetic groups were compared, as well as the relationship between frailty and age, dependency, comorbidity, and fall hazard was analyzed. Results: A hundred and twenty-eight patients were included in the study. 45% had diabetes. Diabetic patients had a higher average age than non-diabetics (74.2±11 vs 67.8±15 years) and higher comorbidity (Charlson 8.2±2.2 vs 5.8±2.4). Twenty-five percent of the patients had frailty, observing a trend that suggests higher frailty, worse functional capacity, and a higher degree of dependency in diabetic patients, although not significantly. Conclusions: A quarter of the sampled analyzed presents frailty, with a more pronounced tendency to suffer from it in the case of diabetic patients, which could be related to older age, higher comorbidity, and less functional capacity than non-diabetic people.