Prevalence and risk factors of pre-frailty and frailty in hemodialysis patients in central China

Abstract

The current study was to explore the prevalence and risk factors elements of pre-frailty and frailty among patients undergoing hemodialysis (HD) in central China. A cross-sectional, multi-institutional investigation was conducted. From March to May 2024, using the convenience sampling method, a total of 408 HD patients from four hospitals in Xiangyang, China, were recruited for this study. The participants' demographics, lifestyle factors, factors related to dialysis treatment, the FRAIL scale, psychological resilience, and medical coping modes were assessed using a questionnaire. Multi-categorical logistic regression was performed to examine factors associated with pre-frailty and frailty in this population. Furthermore, to evaluate the independent relationship between frailty and psychological resilience, multiple regression analysis was used to adjust potential confounders and obtain odds ratios (OR) and 95% confidence intervals (CI). Pearson correlation analysis was used for correlation analysis among various scales. Among the 408 participants, the prevalence of pre-frailty and frailty among participants for all ages was 26.2% and 38.5%. Multivariate logistic regression analysis showed that smoking status, falls, heart disease, and psychological resilience are all associated with pre-frailty and frailty. The Pearson correlation analysis showed that resignation was positively related to frailty and negatively related to psychological resilience in patients. Confrontation and avoidance were positively related to psychological resilience. Frailty was negatively related to psychological resilience. Psychological resilience was independently linearly associated with pre-frailty (OR 0.49, 95% CI 0.32-0.75, p < 0.001) and frailty (OR 0.53, 95% CI 0.35-0.80, p = 0.003). Our findings point to the necessity for active screening prevalence and risk factors for pre-frailty (26.2%) and frailty (38.5%) in adult HD patients of all ages. Pre-frailty and frailty among HD patients are associated with lower psychological resilience and a higher likelihood of using negative coping mechanisms.

Keywords: Association; China; Frailty; Hemodialysis; Medical coping modes; Psychological resilience; Risk factors.