We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Quality of life may be a more valuable prognostic factor than depression in older hemodialysis patients.
- Authors
de Alencar, Saulo Barbosa Vasconcelos; Dias, Luana do Amaral; Dias, Victor do Amaral; de Lima, Fábia Maria; Montarroyos, Ulisses Ramos; de Petribú, Kátia Cristina Lima
- Abstract
<bold>Purpose: </bold>Depression and impairment of quality of life (QoL) reduce the survival of individual on hemodialysis (HD). However, few studies evaluated the impact of these conditions on the survival of older patients undergoing HD.<bold>Methods: </bold>A retrospective cohort study was performed including patients aged ≥ 60 years on HD in Recife, Brazil, assessed in 2013 and monitored until 2017. Depression was evaluated with the Mini-International Neuropsychiatric Interview and QoL with the Control, Autonomy, Self-realization, and Pleasure Questionnaire (CASP-16). Survival differences according to the depression and QoL status were measured by Kaplan-Meier analysis and Cox regression. Death Certificates were analyzed to assess the cause of death.<bold>Results: </bold>A total of 171 patients were included (mean age 68.7 ± 6.9 years). The mean follow-up time was 3 years (maximum 4.5 years) and there were 98 deaths (57.3% of the sample). In a multivariate model that included depression and QoL, only QoL impairment was associated with a higher risk of death (HR 1.62, p = 0.035). Among CASP domains, only "Control" was associated with survival (HR 0.90, p = 0.014). Depression was unrelated to the cause of death, but there was a trend for death by endocrine diseases if QoL was impaired (p = 0.057).<bold>Conclusion: </bold>QoL impairment is a key predictor of prognosis in older patients on HD and may be more important than depression. It is important that teams dealing with this population include in protocols an assessment of QoL, in order to offer a range of care according to the needs of these patients.
- Subjects
RECIFE (Brazil); OLDER patients; HEMODIALYSIS patients; QUALITY of life; REGRESSION analysis; DEATH certificates
- Publication
Quality of Life Research, 2020, Vol 29, Issue 7, p1829
- ISSN
0962-9343
- Publication type
journal article
- DOI
10.1007/s11136-020-02445-1