Kidney Week

Abstract: TH-PO930

Patient Activation Impacts Physical Activity in Older Adults with CKD

Session Information

• Geriatric Nephrology: Innovations and Insights
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Geriatric Nephrology

• 1300 Geriatric Nephrology

Authors

• Mirpuri, Karan K., Washington University in St Louis, St Louis, Missouri, United States

Karan K. Mirpuri

• Roach, Christopher N., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Christopher N. Roach

• Woodall, Emily Mai, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Emily Mai Woodall

• Prigmore, Heather Leanne, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Heather Leanne Prigmore, MPH

• Greevy, Robert, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Robert Greevy, PhD

• Cukor, Daniel, Rogosin Institute, New York, New York, United States

Daniel Cukor, PhD

• Taylor, Warren D., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Warren D. Taylor, MD, MHS

• Umeukeje, Ebele M., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Ebele M. Umeukeje, MD, MPH, FASN

• Fissell, Rachel B., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Rachel B. Fissell, MD, MS

• Cavanaugh, Kerri L., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Kerri L. Cavanaugh, MD, MHS, FASN

• Nair, Devika, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Devika Nair, MD, MS, FASN

Background

Older adults with Stage 3B-5 chronic kidney disease (CKD) experience high mortality due to cardiovascular disease. Though physical activity reduces cardiovascular risk, most older adults with CKD are sedentary. The few physical activity interventions for this group face high drop-out, potentially because they do not target factors that strongly impact activity. We tested whether Patient Activation, a modifiable psychological construct of knowledge, confidence, and skill, associates with physical activity frequency in older adults with CKD to explore its utility as an intervention target.

Methods

In a cross-sectional multi-site study, we collected validated psychological (including Patient Activation Measure-13 (PAM-13); 0-100, Levels 1-4) and physiologic (including Montreal Cognitive Assessment, Physical Frailty Phenotype) factors. Physical activity was measured with the first question of the validated Exercise Vital Sign, a report of the average days/week of moderate-to-vigorous physical activity. Comorbidities were obtained from the medical record.

Results

In 231 older adults with Stage 3B-5 CKD (median age 69, 46% women, 26% Black), median PAM-13 was 65.50 (Interquartile Range (IQR) [55.60, 75]). Higher Activation associated with more frequent days of moderate-to-vigorous physical activity. Adjusting for demographics, hemoglobin, body mass index, cognition, comorbidities, instrumental support, depression, anxiety, literacy, pain, and fatigue, a 19.4 point, or 1 IQR difference in PAM-13 associated with a 0.83 (95% Confidence Interval (CI) [0.36, 1.31]; p<0.001) increase in activity days. On average, frailty associated with fewer activity days, -1.89 (95% CI [-3.07, -0.71]); p<0.01).

Conclusion

Older adults with CKD reporting higher Activation also reported more frequent moderate-to-vigorous physical activity, independent of many conceptually relevant covariates.

Funding

• NIDDK Support