Functional impairment, depression, and life satisfaction among older hemodialysis patients and age-matched controls: A prospective study

Objective: To compare change over time in functional impairment, depression, and life satisfaction among older dialysis patients and age-matched controls. Design: Prospective cohort study over 3 years. Setting: Urban and rural communities throughout Georgia. Subjects: One hundred thirteen prevalent renal failure patients on in-center hemodialysis and 286 controls. Main Outcome Measures: Ordinal functional impairment index and life satisfaction rating, and Center for Epidemiologic Studies Depression Scale. Results: Dialysis patients, compared with controls, reported significantly more functional impairment at baseline, and also at follow-up after adjusting for baseline impairment rind covariates. Dialysis patients had higher depression scores at baseline, and also at follow-up after adjusting for baseline depression and covariates. In contrast, dialysis patients reported lower life satisfaction at baseline than did controls, but the two cohorts were not significantly different on reported life satisfaction at follow-up, after adjusting for baseline life satisfaction and race. In both cohorts, functional impairment and depression were significantly related. Conclusion: Older dialysis patients' life satisfaction at a 3-year follow-up, which was similar to life satisfaction among age-matched controls, indicates the value of delivered dialysis care; the value of this care would be increased by reducing excess functional impairment in these patients.