Factors Associated with Depressive Symptoms in Hemodialysis Patients: An Age-specific Analysis From a Multicenter Cross-sectional Study.

Associations between depressive symptoms and clinical factors in hemodialysis patients may differ by age. This study investigated age-related differences in factors linked to depressive symptoms. We analyzed 783 hemodialysis outpatients (582 aged ≥65; 201 <65). Depressive symptoms were defined as a Geriatric Depression Scale-5 score ≥2. Clinical data included CRP, grip strength, Short Physical Performance Battery (SPPB), Kt/V, Geriatric Nutritional Risk Index (GNRI), Intact-PTH, and self-reported stress. Prevalence was compared by Chi-square test. Associations in each age group were assessed by logistic regression. Depressive symptoms were less common in elderly (45.5%) than non-elderly patients (59.7%). Stress was significantly associated with depressive symptoms in non-elderly patients [OR: 2.42 (1.25-4.67)]. Low SPPB [OR: 0.92 (0.87-0.97)] and stress [OR: 2.01 (1.39-2.89)] were significant in elderly patients. Stress management was an important issue for both elderly and non-elderly hemodialysis patients. In particular, it was suggested that the importance of exercise therapy for reducing depressive symptoms may differ between elderly and non-elderly hemodialysis patients.