Hopelessness and Depression Predict Sarcopenia in Advanced CKD and Dialysis: A Multicenter Cohort Study.
BACKGROUND/OBJECTIVES
Depression and hopelessness are frequently experienced in chronic kidney disease (CKD) and are generally associated with lessened physical activity. The aim of this study was to quantify the associations between sarcopenia as determined by SARC-F with both depression and hopelessness.


DESIGN AND SETTING
This multicenter cohort study involving cross-sectional and longitudinal analyses was conducted in a university hospital and four general hospitals, each with a nephrology center, in Japan.


PARTICIPANTS
Participants consisted of 314 CKD patients (mean age 67.6), some of whom were receiving dialysis (228, 73%).


MEASUREMENTS
The main exposures were depression, measured using the Center for Epidemiologic Studies Depression (CES-D) questionnaire, and hopelessness, measured using a recently developed 18-item health-related hope scale (HR-Hope). The outcomes were sarcopenia at baseline and one year after, measured using the SARC-F questionnaire. Logistic regression models were applied.


RESULTS
The cross-sectional and longitudinal analyses included 314 and 180 patients, respectively. Eighty-nine (28.3%) patients experienced sarcopenia at baseline, and 44 (24.4%) had sarcopenia at the one-year follow-up. More hopelessness (per 10-point lower, adjusted odds ratio [AOR]: 1.33, 95% confidence interval [95% CI] 1.12-1.58), depression (AOR: 1.87, 95% CI 1.003-3.49), age (per 10-year higher, AOR: 1.70, 95% CI 1.29-2.25), being female (AOR: 2.67, 95% CI 1.43-4.98), and undergoing hemodialysis (AOR, 2.92; 95% CI, 1.41-6.05) were associated with a higher likelihood of having baseline sarcopenia. More hopelessness (per 10-point lower, AOR: 1.69, 95% CI 1.14-2.51) and depression (AOR: 4.64, 95% CI: 1.33-16.2) were associated with a higher likelihood of having sarcopenia after one year.


CONCLUSIONS
Among patients with different stages of CKD, both hopelessness and depression predicted sarcopenia. Provision of antidepressant therapies or goal-oriented educational programs to alleviate depression or hopelessness can be useful options to prevent sarcopenia.
['Kurita|N|N|', 'Wakita|T|T|', 'Fujimoto|S|S|', 'Yanagi|M|M|', 'Koitabashi|K|K|', 'Suzuki|T|T|', 'Yazawa|M|M|', 'Kawarazaki|H|H|', 'Shibagaki|Y|Y|', 'Ishibashi|Y|Y|']
D000368:Aged D015331:Cohort Studies D003430:Cross-Sectional Studies D003863:Depression D005260:Female D065026:Hope D006801:Humans D008297:Male D006435:Renal Dialysis D051436:Renal Insufficiency, Chronic D055948:Sarcopenia
hopelessness Depression sarcopenia chronic kidney disease health-related hope