Association of Nutritional Status with Depression and Sleep Disorders in Elderly End Stage Renal Disease Patients - Does Chronic Inflammation Cause it all?

OBJECTIVE: In our study we aimed to analyze the association between nutritional status and depression and sleep disturbance in elderly dialysis patients.

MATERIAL and METHODS: Seventy-three patients receiving dialysis treatment older than 65 years of age were enrolled in this study. Nutritional status was determined by Subjective Global Assessment (SGA). Patients were also evaluated with Beck Depression Inventory and Pittsburg Sleep Quality Index. Demographic and laboratory data were recorded.

RESULTS: According to SGA, 48 (65.8%) patients were well nourished and 25 (34.2%) patients had mild-moderate and severe malnutrition. When the well-nourished and malnourished patients were compared, the well-nourished group had higher albumin (p<.0001) and creatinine (p=.03) levels, higher body mass indices (p<.01), lower CRP levels (p<.0001), better quality of sleep (p<.0001) and lower depression scores (p<.0001) than the malnourished group. When we grouped patients as Group I (not depressive and good sleep quality), Group II (depressive but good sleep quality) and Group III (both depressive and poor sleep quality, we found that Group III had the lowest albumin (p < .0001) and highest CRP (p < .0001) values when compared to the other two groups.

CONCLUSION: Depression, sleep disorders, and the nutritional status are important factors which interact with each other and elderly dialysis patients with malnutrition should be well assessed for the presence of any inflammatory status and/or psychological-sleep disorders.