Abstract: TH-PO657
The Association of Depression with Geriatric Conditions in Older Adults with CKD
Session Information
- Geriatric Nephrology
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Geriatric Nephrology
- 1100 Geriatric Nephrology
Authors
- Liu, Christine, Boston University School of Medicine, Boston, Massachusetts, United States
- Giffuni, Jamie, Baltimore Veterans Affairs Medical Center, Baltimore, Maryland, United States
- Reid, Kieran, Tufts University, Boston, Massachusetts, United States
- Waikar, Sushrut S., Harvard Medical School, Boston, Massachusetts, United States
- Seliger, Stephen L., University of Maryland School of Medicine, Baltimore, Maryland, United States
- Weiner, Daniel E., Tufts University, Boston, Massachusetts, United States
Background
Depression is common in CKD and is associated with increased mortality. Geriatric conditions are constellations of signs and symptoms that are usually multifactorial in origin. Many geriatric conditions are associated with increased mortality. Examples of geriatric conditions include cognitive impairment or dizziness. Given depression and geriatric conditions both impact mortality, the presence of both may have additive or synergistic effects in CKD. Our goal was to examin e if depressive symptoms were cross-sectionally associated with the frequency of geriatric conditions in older adults with CKD.
Methods
Baseline data from the Aerobics, Weights, and Renal Disease Study, a randomized trial of exercise in community-dwelling adults 55+ years with stage 3b-4 CKD, were used. The independent variable was depressive symptoms, defined as Beck Depression Inventory score ≥ 10 points (range 0 to 63). The dependent variable was number of geriatric conditions (cognitive impairment, poor physical function, dizziness, fatigue, and chronic pain). Cognitive impairment was defined as Montreal Cognitive Assessment < 26; poor physical function as Short Physical Performance Battery ≤ 7; dizziness as reported on the Memorial Symptom Assessment Scale; fatigue if responded ≥ “good bit of time” to feeling worn out on Short Form-36 (SF-36); and chronic pain if answered ≥ “moderate” pain on SF-36. A generalized linear regression model adjusting for age, sex, race, study site, BMI, diabetes, hypertension, and eGFR was used.
Results
Of 99 persons (25% female, 61% African-American, mean age 68.0±8.2 years, mean BMI 31.1±6.6 kg/m2, mean eGFR 33.1±9.2 ml/min/1.73m2), mean BDI score was 7.2±6.1 points (range 0 to 31) points. Mean number of geriatric conditions was 1.7±1.0 (median 1, IQR 1). After adjustment, depressive symptoms were associated with more geriatric conditions (β coefficient = 0.5129 (95% CI 0.0468, 1.000, p value = 0.03). Persons with depressive symptoms had 1.9 geriatric conditions (least square means), while those without depression symptoms had 1.4 geriatric conditions (least square means).
Conclusion
In older adults with CKD, depressive symptoms correlated with the frequency of geriatric conditions. Future studies should investigate how geriatric conditions may worsen poor health outcomes in CKD patients with depression.
Funding
- NIDDK Support