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Nima Farhadi1 
, Soroush Khorramdel1 , Maryam Pourshams *2 , Saeid Bitaraf3 , Maryam Khombi Shooshtari4 , Fatemeh Hayati4 , Shahla Ahmadi Halili4
, Soroush Khorramdel1 , Maryam Pourshams *2 , Saeid Bitaraf3 , Maryam Khombi Shooshtari4 , Fatemeh Hayati4 , Shahla Ahmadi Halili4
1- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2- Department of Psychiatry, School of Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ,drpourshams@gmail.com
3- Department of Community Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
4- Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2- Department of Psychiatry, School of Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. ,
3- Department of Community Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
4- Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Abstract: (45 Views)
Background: Chronic kidney disease and end-stage renal disease are major public health challenges and are associated with substantial physical and psychiatric consequences. Major depressive disorder and neurocognitive disorders are among the leading contributors to reduced quality of life in elderly patients undergoing hemodialysis. Given the limited local data in southern Iran, this study aimed to determine the prevalence of these disorders and associated factors.
Methods: In this analytical cross-sectional study, 104 elderly hemodialysis patients from three treatment centers in Ahvaz were recruited using convenience sampling. Data were collected using standardized questionnaires, including the Persian versions of the MoCA, BDI-II, and AD8, along with a semi-structured clinical interview (SCID-5) based on DSM-5 criteria. Statistical analyses were performed using independent t-test, chi-square test, and linear regression in SPSS version 26, with significance set at P<0.05.
Results: The frequency of major depressive disorder, mild neurocognitive disorder, major neurocognitive disorder, and DSM-5-based neurocognitive disorder was 43.24%, 27.88%, 9.62%, and 37.5%, respectively. Depression severity (BDI-II) was significantly correlated with longer duration of chronic kidney disease and lower cognitive performance (P<0.01). AD8 scores were considerably higher in patients with major depressive disorder (P<0.001). A history of ischemic heart disease (P=0.025) and cerebrovascular events (P=0.050) was more common among those with major neurocognitive disorder.
Conclusion: The high frequency of depression and neurocognitive disorders among elderly hemodialysis patients highlights the need for routine psychiatric assessment and cognitive screening. A multidisciplinary care approach may help reduce adverse outcomes and improve quality of life in this population.
Methods: In this analytical cross-sectional study, 104 elderly hemodialysis patients from three treatment centers in Ahvaz were recruited using convenience sampling. Data were collected using standardized questionnaires, including the Persian versions of the MoCA, BDI-II, and AD8, along with a semi-structured clinical interview (SCID-5) based on DSM-5 criteria. Statistical analyses were performed using independent t-test, chi-square test, and linear regression in SPSS version 26, with significance set at P<0.05.
Results: The frequency of major depressive disorder, mild neurocognitive disorder, major neurocognitive disorder, and DSM-5-based neurocognitive disorder was 43.24%, 27.88%, 9.62%, and 37.5%, respectively. Depression severity (BDI-II) was significantly correlated with longer duration of chronic kidney disease and lower cognitive performance (P<0.01). AD8 scores were considerably higher in patients with major depressive disorder (P<0.001). A history of ischemic heart disease (P=0.025) and cerebrovascular events (P=0.050) was more common among those with major neurocognitive disorder.
Conclusion: The high frequency of depression and neurocognitive disorders among elderly hemodialysis patients highlights the need for routine psychiatric assessment and cognitive screening. A multidisciplinary care approach may help reduce adverse outcomes and improve quality of life in this population.
Keywords: Elderly, Chronic kidney disease, End-stage renal disease, Major depressive disorder, Neurocognitive disorders
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