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Loss of Appendicular muscle mass in haemodialysis patients is associated with increased self-reported depression, anxiety and lower general health scores

Alston, H; Burns, A; Davenport, A; (2018) Loss of Appendicular muscle mass in haemodialysis patients is associated with increased self-reported depression, anxiety and lower general health scores. Nephrology , 23 (6) pp. 546-551. 10.1111/nep.13075. Green open access

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Abstract

AIMS: Depressive symptoms are commonly reported by haemodialysis (HD) patients. Previous reports have suggested an association between depression and nutritional status. To investigate this, we measured muscle mass in HD patients screened for depression. METHODS: The Beck Depression Inventory-II (BDI-II), Hospital Anxiety and Depression Scale (HADS) were used to screen for depression, and quality of life assessed by the short form 36 (SF36), and measured appendicular lean mass (ALM) post-dialysis with segmental bioimpedance. RESULTS: We studied 113 patients, 84 (74.3%) male, mean age 64.9 ± 14.9 years, median duration of haemodialysis 27.0 (15.7-61.0) months, body mass index (BMI) post-dialysis 25.2 (22.8-28.6) kg/m(2) , ALM index 6.98 (6.22-8.10) kg/m(2) . BDI-II 11 (4-17), HADS 10 (5-16.5), and SF36 average 43.3(36.6-48.4). Lower ALM index was associated with greater BDI-II and HADS depression scores (r = 0.29, p = 0.008; r = 0.27, p = 0.012) respectively, and higher ALM index associated with improved scores on the SF36 physical functioning and general health subscales (r = 0.34, p = 0.001; r = 0.26, p = 0.019), respectively. On logistic regression, lower ALM index was independently associated with high HADS cut off ≥8 (standardised β-0.31, p = 0.007). There were no associations with weight, BMI or fat index. Greater extracellular water both pre- and post-dialysis was associated with reduced SF36 physical functioning (r = -0.24, p = 0.011, r = -0.22, p = 0.26), respectively. CONCLUSION: This is the first report showing an association between ALM index and increased self-reported depression, anxiety and decreased general health. Whether treatment programs designed to improve muscle mass, can lead to reduced levels of depression, and anxiety and improved perceived general health, remains to be determined.

Type: Article
Title: Loss of Appendicular muscle mass in haemodialysis patients is associated with increased self-reported depression, anxiety and lower general health scores
Location: Australia
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/nep.13075
Publisher version: http://doi.org/10.1111/nep.13075
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Appendicular muscle mass, bioimpedance, haemodialysis, sarcopenia co-morbidity
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/1557841
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