Published online Jul 19, 2026. doi: 10.5498/wjp.117143
Revised: February 10, 2026
Accepted: March 16, 2026
Published online: July 19, 2026
Processing time: 162 Days and 22.8 Hours
Elderly patients undergoing hemodialysis are highly susceptible to depression and anxiety; however, their treatment status remains inadequately characterized.
To investigate the prevalence of comorbid depression and anxiety disorders and to identify associated factors among elderly hemodialysis patients admitted to our hospital between June 2022 and June 2025, and to evaluate the treatment gap.
Clinical data were retrospectively collected from 300 elderly patients undergoing maintenance hemodialysis during the study period. Descriptive analyses assessed the prevalence of comorbid depression and/or anxiety and the treatment gap. Univariate and multivariate logistic regression analyses identified factors asso
Among the 300 patients, 114 met the diagnostic criteria for depression and/or anxiety disorders, corresponding to a prevalence of 38.0% (114/300). Of these, 75 (65.8%) were untreated or inadequately treated, indicating a considerable treatment gap. Multivariate analysis revealed that female sex [odds ratio (OR) = 2.15, 95% confidence interval (CI): 1.32-3.51], living alone (OR = 2.89, 95%CI: 1.72-4.85), dialysis duration ≥ 3 years (OR = 1.98, 95%CI: 1.21-3.24), serum albumin < 35 g/L (OR = 2.41, 95%CI: 1.45-4.01), and Charlson Comorbidity Index ≥ 5 (OR = 2.67, 95%CI: 1.63-4.38) were independent risk factors for comorbid depression and/or anxiety (P < 0.05). Advanced age (OR = 1.12, 95%CI: 1.03-1.21) and education level of primary school or below (OR = 3.01, 95%CI: 1.23-7.36) were independent risk factors for a treatment gap, whereas having a confirmed psychiatric diagnosis was protective (OR = 0.21, 95%CI: 0.08-0.53; P < 0.05).
Elderly haemodialysis patients are very likely to have depression and anxiety as well as their main health problem, and there is still a big difference between the number of people who receive treatment and the number of people who need it. If a woman lives alone, if she has had dialysis for a long time, if she has low albumin levels, and if her Charlson Comorbidity Index score is high, she is more likely to have depression and/or anxiety. Older age and lower education can mean that she does not get the treatment she needs. A confirmed psychiatric diagnosis markedly reduces this gap. This population’s outcomes and quality of life can be improved by enhanced psychological screening, timely intervention for high-risk individuals and multidisciplinary collaboration.
Core Tip: Among elderly patients with hemodialysis, the prevalence of depression and anxiety was 38.0 %, with 65.8 % exhibiting a treatment gap. Female sex, living alone, longer hemodialysis duration, hypoalbuminemia, and higher Charlson Comorbidity Index scores were risk factors, whereas a confirmed psychiatric diagnosis significantly reduced the treatment gap.