6847 HEALTH-RELATED QUALITY OF LIFE AND SYMPTOM BURDEN IN YOUNGER AND OLDER HAEMODIALYSIS PATIENTS: A PROSPECTIVE COHORT STUDY

Abstract Background and Aims Patients on haemodialysis generally report poor health-related quality of life (HRQoL) and a broad range of physical and emotional symptoms, but it is unknown if this differs between younger and older patients. We aimed to describe the trajectories of HRQoL and symptom burden of patients < 70 and ≥ 70 years old after dialysis initiation and to assess the impact of symptom burden on HRQoL. Method Incident Dutch haemodialysis patients were included between December 1st, 2017, and January 19th, 2019. HRQoL and symptom were measured with the 12-item Short Form Health Survey (range 0-100, higher scores indicate better HRQoL) and the Dialysis Symptom Index (range 0-150, higher scores indicate more symptoms and/or higher severity). Questionnaires were taken at the start of dialysis and after 3, 6 and 12 months. We used (multilevel) linear regression to examine the trajectories of HRQOL and symptom burden, and the impact of symptom burden on HRQoL. Results In 774 patients, the trajectories of physical HRQoL, mental HRQoL and symptom burden were stable. Compared with patients aged < 70 years, patients ≥ 70 years reported similar physical HRQoL (crude mean difference -0.61, 95% CI -1.86; 0.63, p = .33) but slightly better mental HRQoL (1.77, 95% CI 0.54; 3.01, p = .005) and lower symptom burden (-2.38, 95% CI -5.08; 0.32, p = .08) during the first year of dialysis. With increasing symptom burden, physical HRQoL declined more in older than in younger patients (β -.287 versus β -.189, respectively, p-value for interaction = .007). For mental HRQoL, this decrease was similar (β -.295 versus -.288, p-value for interaction = .847). Conclusion Older haemodialysis patients generally experience better mental HRQoL and a (non-statistically significant) lower symptom burden in the first year after dialysis initiation, compared to younger patients. However, their physical HRQoL declines more rapidly with increasing symptom burden, compared to younger patients.