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Depressive symptoms in older adults with chronic kidney disease: mortality, quality of life outcomes, and correlates.
Am J Geriatr Psychiatry. 2013 Jun; 21(6):570-9.AJ

Abstract

OBJECTIVE

Among patients with chronic kidney disease (CKD), we investigated the prevalence of depressive symptoms, their impact on mortality and quality of life, and correlates of depressive symptoms.

DESIGN

Prospective cohort study, followed up to 4 years.

SETTING

General community.

PARTICIPANTS

A total of 362 older adults with CKD (Stages 3 and 4 assessed from estimated glomerular filtration rate [eGFR]) drawn from the Singapore Longitudinal Aging Study cohort.

MEASUREMENTS

Scores on the Geriatric Depression Scale (GDS) and the prevalence of depressive symptoms (GDS ≥5) and other variables were assessed at baseline, and SF-12 quality of life (QOL) (at 2 years) and mortality determined from 4 years of follow-up.

RESULTS

Depressive symptoms were present in 13% of the participants at baseline, and were associated with poorer SF-12 QOL scores (up to 30 percentage point differences). There was a significant association between depressive symptoms and increased mortality risk (odds ratio: 3.17; 95% confidence interval: 1.17-8.61; χ(2) = 5.11; df = 1; p = 0.023), which was statistically significant in unadjusted analysis, but not in multivariate analysis that accounted for covariates (odds ratio: 2.62; 95% confidence interval: 0.77-8.89; χ(2) = 2.37; df = 1; p = 0.13). Baseline cognitive impairment, functional disability, and other chronic illness were significantly associated with both increasing GDS scores and depressive symptoms. No relationship between eGFR and depressive symptoms was observed.

CONCLUSION

Depression among individuals with CKD was significantly associated with poorer quality of life, but not with increased mortality in predialysis CKD patients. More prospective studies are needed to establish the effects of depression on adverse CKD outcomes in predialysis CKD patients.

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Authors+Show Affiliations

Feng L
Gerontological Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of PsychologicalMedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Yap KB
No affiliation info available
Ng TP
No affiliation info available

MeSH

Activities of Daily LivingAgedCase-Control StudiesCognition DisordersDepressionDisability EvaluationFemaleGlomerular Filtration RateHealth StatusHumansMaleMiddle AgedPrevalenceProspective StudiesQuality of LifeRenal Insufficiency, ChronicRisk FactorsSingapore

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23567405

Citation

Feng, Liang, et al. "Depressive Symptoms in Older Adults With Chronic Kidney Disease: Mortality, Quality of Life Outcomes, and Correlates." The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, vol. 21, no. 6, 2013, pp. 570-9.
Feng L, Yap KB, Ng TP. Depressive symptoms in older adults with chronic kidney disease: mortality, quality of life outcomes, and correlates. Am J Geriatr Psychiatry. 2013;21(6):570-9.
Feng, L., Yap, K. B., & Ng, T. P. (2013). Depressive symptoms in older adults with chronic kidney disease: mortality, quality of life outcomes, and correlates. The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry, 21(6), 570-9. https://doi.org/10.1016/j.jagp.2012.12.020
Feng L, Yap KB, Ng TP. Depressive Symptoms in Older Adults With Chronic Kidney Disease: Mortality, Quality of Life Outcomes, and Correlates. Am J Geriatr Psychiatry. 2013;21(6):570-9. PubMed PMID: 23567405.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depressive symptoms in older adults with chronic kidney disease: mortality, quality of life outcomes, and correlates. AU - Feng,Liang, AU - Yap,Keng Bee, AU - Ng,Tze Pin, Y1 - 2013/01/18/ PY - 2010/11/16/received PY - 2011/11/27/revised PY - 2011/12/27/accepted PY - 2013/4/10/entrez PY - 2013/4/10/pubmed PY - 2014/11/5/medline SP - 570 EP - 9 JF - The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry JO - Am J Geriatr Psychiatry VL - 21 IS - 6 N2 - OBJECTIVE: Among patients with chronic kidney disease (CKD), we investigated the prevalence of depressive symptoms, their impact on mortality and quality of life, and correlates of depressive symptoms. DESIGN: Prospective cohort study, followed up to 4 years. SETTING: General community. PARTICIPANTS: A total of 362 older adults with CKD (Stages 3 and 4 assessed from estimated glomerular filtration rate [eGFR]) drawn from the Singapore Longitudinal Aging Study cohort. MEASUREMENTS: Scores on the Geriatric Depression Scale (GDS) and the prevalence of depressive symptoms (GDS ≥5) and other variables were assessed at baseline, and SF-12 quality of life (QOL) (at 2 years) and mortality determined from 4 years of follow-up. RESULTS: Depressive symptoms were present in 13% of the participants at baseline, and were associated with poorer SF-12 QOL scores (up to 30 percentage point differences). There was a significant association between depressive symptoms and increased mortality risk (odds ratio: 3.17; 95% confidence interval: 1.17-8.61; χ(2) = 5.11; df = 1; p = 0.023), which was statistically significant in unadjusted analysis, but not in multivariate analysis that accounted for covariates (odds ratio: 2.62; 95% confidence interval: 0.77-8.89; χ(2) = 2.37; df = 1; p = 0.13). Baseline cognitive impairment, functional disability, and other chronic illness were significantly associated with both increasing GDS scores and depressive symptoms. No relationship between eGFR and depressive symptoms was observed. CONCLUSION: Depression among individuals with CKD was significantly associated with poorer quality of life, but not with increased mortality in predialysis CKD patients. More prospective studies are needed to establish the effects of depression on adverse CKD outcomes in predialysis CKD patients. SN - 1545-7214 UR - https://www.unboundmedicine.com/medline/citation/23567405/Depressive_symptoms_in_older_adults_with_chronic_kidney_disease:_mortality_quality_of_life_outcomes_and_correlates_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1064-7481(12)00117-0 DB - PRIME DP - Unbound Medicine ER -