Older haemodialysis patients often experience better mental quality of life and lower symptom burden, study suggests

quality of life
Mathijs van Oevelen

A research team led by Mathijs van Oevelen (Leiden University Medical Center, Leiden, The Netherlands) has examined health-related quality of life (HRQoL) in chronic kidney disease (CKD) patients undergoing haemodialysis according to age. Their findings suggest that patients who are ≥70 years old “generally experience a better mental HRQoL”. 

Van Oevelen et al contend in their introduction that it is “unknown whether [HRQoL] differs between older and younger patients”; therefore, they set out to “describe the trajectories of HRQoL and symptom burden” of patients aged ≥70 years old compared with those who are younger. They aimed then to examine the impact on quality of life of symptom burden. 

The study authors used the 12-item Short Form Health Survey and Dialysis Symptom Index to assess HRQoL and symptom burden in a total of 774 Dutch incident haemodialysis patients. They found that both physical and mental HRQoL—as well as symptom burden—remained “stable” in the first year of treatment with haemodialysis, with linear mixed models used to assess their trajectories. Linear regression was used to examine the effect of symptom burden on HRQoL. 

Patients aged ≥70 years reported similar physical HRQoL (mean difference -0.61; 95% confidence interval [CI] -1.86; 0.63), better mental HRQoL (1.77; 95% CI 0.54; 3.01), and lower symptom burden (-2.38; 95% CI -5.08; 0.32) compared to those younger than 70. As symptom burden increased in the older patient group, however, physical HRQoL declined more rapidly than it did in the younger group (β -0.287 vs. -0.189, respectively; p=0.007). Increased symptom burden demonstrated a similar effect on mental HRQoL in both age groups (β -0.295 vs. -0.288; p=0.847). 

Summarising the findings in their conclusion, van Oevelen and colleagues state that older patients receiving haemodialysis “generally experience a better mental HRQoL and a (non-statistically significant) lower symptom burden compared to younger patients”. This comes despite a more pronounced physical HRQoL decline with increasing symptom burden for older patients, they emphasise finally.


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