Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure
Background Impaired cognition, poor health-related quality of life (HRQoL) and depressive symptoms are common in older patients with kidney failure. Understanding what influences HRQoL is important, as older patients regard HRQoL as a health priority. This study examines whether cognitive functionin...
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| Veröffentlicht in: | Journal of nephrology 2024-09, Vol.37 (7), p.1939-1948 |
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| container_end_page | 1948 |
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| container_issue | 7 |
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| container_title | Journal of nephrology |
| container_volume | 37 |
| creator | Demirhan, Imre van Oevelen, Mathijs Skalli, Zeinab Voorend, Carlijn G. N. Mooijaart, Simon P. Meuleman, Yvette Verhaar, Marianne C. Bos, Willem Jan W. van Buren, Marjolijn Abrahams, Alferso C. |
| description | Background
Impaired cognition, poor health-related quality of life (HRQoL) and depressive symptoms are common in older patients with kidney failure. Understanding what influences HRQoL is important, as older patients regard HRQoL as a health priority. This study examines whether cognitive functioning is associated with HRQoL and whether depressive symptoms mediate this effect in older patients with kidney failure.
Methods
Outpatients aged ≥ 65 years from 35 Dutch and Belgian hospitals with eGFR 20–10 mL/min/1.73 m
2
were included from the ongoing DIALOGICA study. Cognitive functioning was assessed using the Montreal Cognitive Assessment. Depressive symptoms were screened with 2 Whooley Questions and thereafter assessed with the 15-item Geriatric Depression Scale. HRQoL was assessed using the 12-item Short-Form Health Survey. To assess whether cognitive functioning is associated with HRQoL, cross-sectional multivariable linear regression analyses were performed. Subsequent mediation analyses were performed with PROCESS using the product method.
Results
In total, 403 patients were included, with a mean age of 76.5 years (SD 5.8) and estimated glomerular filtration rate (eGFR) of 14.5 mL/min/1.73 m
2
(SD 3.0). Cognitive functioning was associated with mental HRQoL (adjusted
β
0.30, 95% CI 0.05;0.55) but not physical HRQoL (adjusted
β
0.18, 95% CI -0.09;0.44). This effect is mediated by depressive symptoms (adjusted
β
0.14, 95% CI 0.04;0.25).
Conclusion
Lower cognitive functioning was negatively associated with mental HRQoL, which was mediated by depressive symptoms in older patients with kidney failure. Future research should explore whether cognitive interventions and treatment of depression improve HRQoL in this vulnerable patient population.
Graphical Abstract |
| doi_str_mv | 10.1007/s40620-024-02095-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11519205</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3110401720</sourcerecordid><originalsourceid>FETCH-LOGICAL-c284t-490c9aacce0ac0b83f931ac1077c32cb3bee376034799d263a3f92050bda81fb3</originalsourceid><addsrcrecordid>eNp9kc9u1DAQhy0EoqXwAhyQj1wCYzvZbE6oqvgnVeICZ8txJrsujp16nFZ5Fl4Wb7etyoWDZVvzzeeRf4y9FfBBALQfqYaNhApkXRZ0TaWesVPRlusGmu75k_MJe0V0BSCbRtYv2YnqlGxV056yP-dE0TqTXQy8x3yLGLiNu-Cyu0E-LsEeSi7suAkD36PxeV8l9CbjwK8X411eeRy5dyPeIS4Tn3B4UK58wDkh0UFH6zTnOBF3gUc_YOJzwTCUlluX9_y3GwKufDTOLwlfsxej8YRv7vcz9uvL558X36rLH1-_X5xfVlZu61zVHdjOGGsRjIV-q8ZOCWMFtK1V0vaqR1TtBlTddt0gN8oUQkID_WC2YuzVGft09M5LXya3ZZ5kvJ6Tm0xadTRO_1sJbq938UYL0YiDqRje3xtSvF6Qsp4cWfTeBIwLaSUE1FDigILKI2pTJEo4Pr4jQB9i1cdYdYlV38WqVWl693TCx5aHHAugjgCVUthh0ldxSaH82v-0fwFpU7NM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3110401720</pqid></control><display><type>article</type><title>Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Demirhan, Imre ; van Oevelen, Mathijs ; Skalli, Zeinab ; Voorend, Carlijn G. N. ; Mooijaart, Simon P. ; Meuleman, Yvette ; Verhaar, Marianne C. ; Bos, Willem Jan W. ; van Buren, Marjolijn ; Abrahams, Alferso C.</creator><creatorcontrib>Demirhan, Imre ; van Oevelen, Mathijs ; Skalli, Zeinab ; Voorend, Carlijn G. N. ; Mooijaart, Simon P. ; Meuleman, Yvette ; Verhaar, Marianne C. ; Bos, Willem Jan W. ; van Buren, Marjolijn ; Abrahams, Alferso C. ; DIALOGICA study group</creatorcontrib><description>Background
Impaired cognition, poor health-related quality of life (HRQoL) and depressive symptoms are common in older patients with kidney failure. Understanding what influences HRQoL is important, as older patients regard HRQoL as a health priority. This study examines whether cognitive functioning is associated with HRQoL and whether depressive symptoms mediate this effect in older patients with kidney failure.
Methods
Outpatients aged ≥ 65 years from 35 Dutch and Belgian hospitals with eGFR 20–10 mL/min/1.73 m
2
were included from the ongoing DIALOGICA study. Cognitive functioning was assessed using the Montreal Cognitive Assessment. Depressive symptoms were screened with 2 Whooley Questions and thereafter assessed with the 15-item Geriatric Depression Scale. HRQoL was assessed using the 12-item Short-Form Health Survey. To assess whether cognitive functioning is associated with HRQoL, cross-sectional multivariable linear regression analyses were performed. Subsequent mediation analyses were performed with PROCESS using the product method.
Results
In total, 403 patients were included, with a mean age of 76.5 years (SD 5.8) and estimated glomerular filtration rate (eGFR) of 14.5 mL/min/1.73 m
2
(SD 3.0). Cognitive functioning was associated with mental HRQoL (adjusted
β
0.30, 95% CI 0.05;0.55) but not physical HRQoL (adjusted
β
0.18, 95% CI -0.09;0.44). This effect is mediated by depressive symptoms (adjusted
β
0.14, 95% CI 0.04;0.25).
Conclusion
Lower cognitive functioning was negatively associated with mental HRQoL, which was mediated by depressive symptoms in older patients with kidney failure. Future research should explore whether cognitive interventions and treatment of depression improve HRQoL in this vulnerable patient population.
Graphical Abstract</description><identifier>ISSN: 1724-6059</identifier><identifier>ISSN: 1121-8428</identifier><identifier>EISSN: 1724-6059</identifier><identifier>DOI: 10.1007/s40620-024-02095-3</identifier><identifier>PMID: 39327357</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Aged, 80 and over ; Belgium - epidemiology ; Cognition ; Cognitive Dysfunction - epidemiology ; Cognitive Dysfunction - psychology ; Cross-Sectional Studies ; Depression - epidemiology ; Depression - psychology ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Mediation Analysis ; Medicine ; Medicine & Public Health ; Nephrology ; Netherlands - epidemiology ; Original ; Original Article ; Quality of Life ; Renal Insufficiency - epidemiology ; Renal Insufficiency - physiopathology ; Renal Insufficiency - psychology ; Urology</subject><ispartof>Journal of nephrology, 2024-09, Vol.37 (7), p.1939-1948</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c284t-490c9aacce0ac0b83f931ac1077c32cb3bee376034799d263a3f92050bda81fb3</cites><orcidid>0009-0000-7615-7176</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40620-024-02095-3$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40620-024-02095-3$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39327357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Demirhan, Imre</creatorcontrib><creatorcontrib>van Oevelen, Mathijs</creatorcontrib><creatorcontrib>Skalli, Zeinab</creatorcontrib><creatorcontrib>Voorend, Carlijn G. N.</creatorcontrib><creatorcontrib>Mooijaart, Simon P.</creatorcontrib><creatorcontrib>Meuleman, Yvette</creatorcontrib><creatorcontrib>Verhaar, Marianne C.</creatorcontrib><creatorcontrib>Bos, Willem Jan W.</creatorcontrib><creatorcontrib>van Buren, Marjolijn</creatorcontrib><creatorcontrib>Abrahams, Alferso C.</creatorcontrib><creatorcontrib>DIALOGICA study group</creatorcontrib><title>Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure</title><title>Journal of nephrology</title><addtitle>J Nephrol</addtitle><addtitle>J Nephrol</addtitle><description>Background
Impaired cognition, poor health-related quality of life (HRQoL) and depressive symptoms are common in older patients with kidney failure. Understanding what influences HRQoL is important, as older patients regard HRQoL as a health priority. This study examines whether cognitive functioning is associated with HRQoL and whether depressive symptoms mediate this effect in older patients with kidney failure.
Methods
Outpatients aged ≥ 65 years from 35 Dutch and Belgian hospitals with eGFR 20–10 mL/min/1.73 m
2
were included from the ongoing DIALOGICA study. Cognitive functioning was assessed using the Montreal Cognitive Assessment. Depressive symptoms were screened with 2 Whooley Questions and thereafter assessed with the 15-item Geriatric Depression Scale. HRQoL was assessed using the 12-item Short-Form Health Survey. To assess whether cognitive functioning is associated with HRQoL, cross-sectional multivariable linear regression analyses were performed. Subsequent mediation analyses were performed with PROCESS using the product method.
Results
In total, 403 patients were included, with a mean age of 76.5 years (SD 5.8) and estimated glomerular filtration rate (eGFR) of 14.5 mL/min/1.73 m
2
(SD 3.0). Cognitive functioning was associated with mental HRQoL (adjusted
β
0.30, 95% CI 0.05;0.55) but not physical HRQoL (adjusted
β
0.18, 95% CI -0.09;0.44). This effect is mediated by depressive symptoms (adjusted
β
0.14, 95% CI 0.04;0.25).
Conclusion
Lower cognitive functioning was negatively associated with mental HRQoL, which was mediated by depressive symptoms in older patients with kidney failure. Future research should explore whether cognitive interventions and treatment of depression improve HRQoL in this vulnerable patient population.
Graphical Abstract</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Belgium - epidemiology</subject><subject>Cognition</subject><subject>Cognitive Dysfunction - epidemiology</subject><subject>Cognitive Dysfunction - psychology</subject><subject>Cross-Sectional Studies</subject><subject>Depression - epidemiology</subject><subject>Depression - psychology</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Mediation Analysis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrology</subject><subject>Netherlands - epidemiology</subject><subject>Original</subject><subject>Original Article</subject><subject>Quality of Life</subject><subject>Renal Insufficiency - epidemiology</subject><subject>Renal Insufficiency - physiopathology</subject><subject>Renal Insufficiency - psychology</subject><subject>Urology</subject><issn>1724-6059</issn><issn>1121-8428</issn><issn>1724-6059</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQhy0EoqXwAhyQj1wCYzvZbE6oqvgnVeICZ8txJrsujp16nFZ5Fl4Wb7etyoWDZVvzzeeRf4y9FfBBALQfqYaNhApkXRZ0TaWesVPRlusGmu75k_MJe0V0BSCbRtYv2YnqlGxV056yP-dE0TqTXQy8x3yLGLiNu-Cyu0E-LsEeSi7suAkD36PxeV8l9CbjwK8X411eeRy5dyPeIS4Tn3B4UK58wDkh0UFH6zTnOBF3gUc_YOJzwTCUlluX9_y3GwKufDTOLwlfsxej8YRv7vcz9uvL558X36rLH1-_X5xfVlZu61zVHdjOGGsRjIV-q8ZOCWMFtK1V0vaqR1TtBlTddt0gN8oUQkID_WC2YuzVGft09M5LXya3ZZ5kvJ6Tm0xadTRO_1sJbq938UYL0YiDqRje3xtSvF6Qsp4cWfTeBIwLaSUE1FDigILKI2pTJEo4Pr4jQB9i1cdYdYlV38WqVWl693TCx5aHHAugjgCVUthh0ldxSaH82v-0fwFpU7NM</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Demirhan, Imre</creator><creator>van Oevelen, Mathijs</creator><creator>Skalli, Zeinab</creator><creator>Voorend, Carlijn G. N.</creator><creator>Mooijaart, Simon P.</creator><creator>Meuleman, Yvette</creator><creator>Verhaar, Marianne C.</creator><creator>Bos, Willem Jan W.</creator><creator>van Buren, Marjolijn</creator><creator>Abrahams, Alferso C.</creator><general>Springer International Publishing</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0009-0000-7615-7176</orcidid></search><sort><creationdate>20240901</creationdate><title>Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure</title><author>Demirhan, Imre ; van Oevelen, Mathijs ; Skalli, Zeinab ; Voorend, Carlijn G. N. ; Mooijaart, Simon P. ; Meuleman, Yvette ; Verhaar, Marianne C. ; Bos, Willem Jan W. ; van Buren, Marjolijn ; Abrahams, Alferso C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c284t-490c9aacce0ac0b83f931ac1077c32cb3bee376034799d263a3f92050bda81fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Belgium - epidemiology</topic><topic>Cognition</topic><topic>Cognitive Dysfunction - epidemiology</topic><topic>Cognitive Dysfunction - psychology</topic><topic>Cross-Sectional Studies</topic><topic>Depression - epidemiology</topic><topic>Depression - psychology</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Mediation Analysis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrology</topic><topic>Netherlands - epidemiology</topic><topic>Original</topic><topic>Original Article</topic><topic>Quality of Life</topic><topic>Renal Insufficiency - epidemiology</topic><topic>Renal Insufficiency - physiopathology</topic><topic>Renal Insufficiency - psychology</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Demirhan, Imre</creatorcontrib><creatorcontrib>van Oevelen, Mathijs</creatorcontrib><creatorcontrib>Skalli, Zeinab</creatorcontrib><creatorcontrib>Voorend, Carlijn G. N.</creatorcontrib><creatorcontrib>Mooijaart, Simon P.</creatorcontrib><creatorcontrib>Meuleman, Yvette</creatorcontrib><creatorcontrib>Verhaar, Marianne C.</creatorcontrib><creatorcontrib>Bos, Willem Jan W.</creatorcontrib><creatorcontrib>van Buren, Marjolijn</creatorcontrib><creatorcontrib>Abrahams, Alferso C.</creatorcontrib><creatorcontrib>DIALOGICA study group</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Demirhan, Imre</au><au>van Oevelen, Mathijs</au><au>Skalli, Zeinab</au><au>Voorend, Carlijn G. N.</au><au>Mooijaart, Simon P.</au><au>Meuleman, Yvette</au><au>Verhaar, Marianne C.</au><au>Bos, Willem Jan W.</au><au>van Buren, Marjolijn</au><au>Abrahams, Alferso C.</au><aucorp>DIALOGICA study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure</atitle><jtitle>Journal of nephrology</jtitle><stitle>J Nephrol</stitle><addtitle>J Nephrol</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>37</volume><issue>7</issue><spage>1939</spage><epage>1948</epage><pages>1939-1948</pages><issn>1724-6059</issn><issn>1121-8428</issn><eissn>1724-6059</eissn><abstract>Background
Impaired cognition, poor health-related quality of life (HRQoL) and depressive symptoms are common in older patients with kidney failure. Understanding what influences HRQoL is important, as older patients regard HRQoL as a health priority. This study examines whether cognitive functioning is associated with HRQoL and whether depressive symptoms mediate this effect in older patients with kidney failure.
Methods
Outpatients aged ≥ 65 years from 35 Dutch and Belgian hospitals with eGFR 20–10 mL/min/1.73 m
2
were included from the ongoing DIALOGICA study. Cognitive functioning was assessed using the Montreal Cognitive Assessment. Depressive symptoms were screened with 2 Whooley Questions and thereafter assessed with the 15-item Geriatric Depression Scale. HRQoL was assessed using the 12-item Short-Form Health Survey. To assess whether cognitive functioning is associated with HRQoL, cross-sectional multivariable linear regression analyses were performed. Subsequent mediation analyses were performed with PROCESS using the product method.
Results
In total, 403 patients were included, with a mean age of 76.5 years (SD 5.8) and estimated glomerular filtration rate (eGFR) of 14.5 mL/min/1.73 m
2
(SD 3.0). Cognitive functioning was associated with mental HRQoL (adjusted
β
0.30, 95% CI 0.05;0.55) but not physical HRQoL (adjusted
β
0.18, 95% CI -0.09;0.44). This effect is mediated by depressive symptoms (adjusted
β
0.14, 95% CI 0.04;0.25).
Conclusion
Lower cognitive functioning was negatively associated with mental HRQoL, which was mediated by depressive symptoms in older patients with kidney failure. Future research should explore whether cognitive interventions and treatment of depression improve HRQoL in this vulnerable patient population.
Graphical Abstract</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39327357</pmid><doi>10.1007/s40620-024-02095-3</doi><tpages>10</tpages><orcidid>https://orcid.org/0009-0000-7615-7176</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1724-6059 |
| ispartof | Journal of nephrology, 2024-09, Vol.37 (7), p.1939-1948 |
| issn | 1724-6059 1121-8428 1724-6059 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11519205 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Aged, 80 and over Belgium - epidemiology Cognition Cognitive Dysfunction - epidemiology Cognitive Dysfunction - psychology Cross-Sectional Studies Depression - epidemiology Depression - psychology Female Glomerular Filtration Rate Humans Male Mediation Analysis Medicine Medicine & Public Health Nephrology Netherlands - epidemiology Original Original Article Quality of Life Renal Insufficiency - epidemiology Renal Insufficiency - physiopathology Renal Insufficiency - psychology Urology |
| title | Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure |
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