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Association between depression symptoms and cognitive frailty in chronic kidney disease patients: a cross-sectional
Peng Zhang1,2, Aiqing Fan3, Nian Xie4
1School of Public Health, Hainan Medical University, Haikou, China.
Insights
Depressive symptoms are linked to cognitive frailty in chronic kidney disease patients. Early screening for depression and psychological support may help reduce cognitive frailty risk.
Area of Science:
- Nephrology
- Gerontology
- Psychiatry
Background:
- Cognitive frailty (CF) and depressive symptoms are common in chronic kidney disease (CKD) patients.
- These conditions can worsen health outcomes, necessitating early intervention.
Purpose of the Study:
- To investigate the association between depressive symptoms and cognitive frailty in CKD patients.
- To provide evidence for early intervention strategies.
Main Methods:
- Data from 800 CKD patients across three Shanghai hospitals were analyzed.
- Depressive symptoms (CES-D scores) and CF status were assessed using standardized questionnaires.
- Logistic regression and restricted cubic spline (RCS) analyses were used to determine the association.
Main Results:
- A significant positive association was found between higher CES-D scores and CF (OR=1.124, p<0.001).
- RCS analysis revealed a nonlinear dose-response relationship, with CF prevalence increasing with CES-D scores up to 9.
- The risk of cognitive frailty became statistically significant at CES-D scores of 12.
Conclusions:
- Depressive symptoms are significantly associated with cognitive frailty in CKD patients.
- Routine screening for depression using the CES-D scale is recommended.
- Psychological support for patients with CES-D scores of 12 or higher may help mitigate cognitive frailty risk.
Objective:
Cognitive frailty (CF) and depressive symptoms are prevalent in patients with chronic kidney disease (CKD) and may synergistically exacerbate adverse health outcomes. This study examined their association to inform early intervention strategies.
Methods:
Demographic and clinical data were collected from CKD patients across three hospitals in Shanghai. Depressive symptoms and CF status were assessed via standardized questionnaires. A logistic regression model and restricted cubic spline (RCS) analysis were employed to evaluate the association between depressive symptoms and CF.
Results:
CF was diagnosed using the Frailty Phenotype (FP), Montreal Cognitive Assessment (MoCA), and Clinical Dementia Rating (CDR). Among 800 participants, 317 exhibited CF (prevalence: 39.6%). The adjusted logistic regression model revealed a significant positive association between Center for Epidemiologic Studies Depression (CES-D) scores and CF (OR=1.124, 95% CI: 1.094-1.156, p<0.001). RCS analysis demonstrated a nonlinear dose-response relationship: CF prevalence increased with rising CES-D scores until plateauing at a score of 9. The odds ratio (OR) exceeded the statistical significance threshold when CES-D scores reached 12. Subgroup analyses consistently supported this dose-response pattern.
Conclusion:
Depressive symptoms are significantly associated with CF in CKD patients. Routine CES-D screening and provision of psychological support for patients scoring ≥12 may mitigate CF risk.
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