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Association of age with risk of major depression among patients with chronic kidney disease over midlife: a nationwide cohort study in Taiwan

Published online by Cambridge University Press:  06 November 2018

Shih-Feng Chen ,
Yu-Huei Chien ,
Pau-Chung Chen  and
I-Jen Wang
Shih-Feng Chen
Affiliation:
Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan
Yu-Huei Chien
Affiliation:
Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan
Pau-Chung Chen
Affiliation:
Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
I-Jen Wang*
Affiliation:
Psychiatry Department, Taipei City Hospital Jen-Ai Branch, Taipei, Taiwan
*
Correspondence should be addressed to: I-Jen Wang, Psychiatry Department, Taipei City Hospital Jen-Ai Branch, No. 10, Sec. 4, Jen-Ai Rd., Taipei 10629, Taiwan (R.O.C.). Phone: +886-2-27093600 ext. 5246; Fax: +886-2-27039788. Email: [email protected]
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Abstract

Background:

The impact of age on the development of depression among patients with chronic kidney disease (CKD) at stages before dialysis is not well known. We aimed to explore the incidence of major depression among predialysis CKD patients of successively older ages through midlife.

Methods:

We conducted a retrospective cohort study using the longitudinal health insurance database 2005 in Taiwan. This study investigated 17,889 predialysis CKD patients who were further categorized into study (i.e. middle and old-aged) groups and comparison group aged 18–44. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was applied for coding diseases.

Results:

The group aged 75 and over had the lowest (hazard ratio [HR] 0.47; 95% confidence interval [CI] 0.32–0.69) risk of developing major depression, followed by the group aged 65–74 (HR 0.67; 95% CI 0.49–0.92), using the comparison group as reference. The adjusted survival curves showed significant differences in cumulative major depression-free survival between different age groups. We observed that the risk of major depression development decreases with higher age. Females were at a higher risk of major depression than males among predialyasis CKD patients.

Conclusions:

The incidence of major depression declines with higher age in predialysis CKD patients over midlife. Among all age groups, patients aged 75 and over have the lowest risk of developing major depression. A female preponderance in major depression development is present. We suggest that depression prevention and therapy should be integrated into the standard care for predialysis CKD patients, especially for those young and female.

Keywords

agemajor depressionchronic kidney diseasepredialysismidliferetrospective cohort study
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 8: Issue Theme: Dementia Care , August 2019 , pp. 1171 - 1179
Copyright
© International Psychogeriatric Association 2018 

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