Symptoms of Depression and Associated Variables in Older Patients on Maintenance Hemodialysis

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BACKGROUND: Depression is common in patients with chronic kidney disease on maintenance hemodialysis. However, depression prevalence and associated variables have been less studied in maintenance hemodialysis patients older than 65 years old. OBJECTIVES: This study aimed to define the prevalence of depression and the associated variables in older patients on maintenance hemodialysis. DESIGN: This is a cross-sectional study. PARTICIPANTS: Participants included 197 older patients on maintenance hemodialysis (age range 65-80) recruited between September 2023 to September 2024 in Italy. MEASUREMENTS: Depression levels were measured with the Beck Depression Inventory II and perceived stress levels with the Perceived Stress Scale. We also collected clinical and laboratory variables. RESULTS: Of 197 patients, 130 patients (66%) had Beck Depression Inventory < 14 and 67 (34%) had Beck Depression Inventory ≥ 14. The two groups differed for age, sex, dialytic age, activity of daily living and instrumental activity of daily living scores, Body Mass Index, post-dialysis fatigue, dialysis recovery time, Perceived Stress Scale score, and serum creatinine. At the logistic regression analysis, the Beck Depression Inventory score was independently associated with female sex, post-dialysis fatigue, low IADL, and Perceived Stress Scale score. Post-dialysis fatigue intensity, duration, and frequency and the post-dialysis fatigue sum were significantly higher in patients with Beck Depression Inventory ≥ 14 than in those with Beck Depression Inventory < 14. The correlation between Beck Depression Inventory and Perceived Stress Scale was statistically significant. Then, we stratified patients according to the score of the Cohen's Perceived Stress Scale into three groups: low stress (0-13), moderate stress (14-26), and severe stress (27-40). Patients with Beck Depression Inventory≥ 14 had a higher frequency of severe perceived stress. CONCLUSIONS: Beck Depression Inventory score was independently associated with female sex, instrumental activity of daily living and Perceived Stress Scale score in older patients on maintenance hemodialysis.

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