Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD study

Abstract Introduction Low physical function and depressive symptoms are frequent in older patients undergoing hemodialysis. This study aimed to investigate the association between life-space mobility (LSM), low physical function, and depressive symptoms in older patients undergoing hemodialysis. Met...

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Main Authors: Sho Kojima, Naoto Usui, Yuki Nishiyama, Nobuhito Shinozaki, Nobuyuki Shirai, Kenta Mikami, Yoichi Sato, Takahumi Noji, Izumi Noda, Yoshifumi Abe, Masakazu Saitoh
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Renal Replacement Therapy
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Online Access:https://doi.org/10.1186/s41100-025-00635-6
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author Sho Kojima
Naoto Usui
Yuki Nishiyama
Nobuhito Shinozaki
Nobuyuki Shirai
Kenta Mikami
Yoichi Sato
Takahumi Noji
Izumi Noda
Yoshifumi Abe
Masakazu Saitoh
author_facet Sho Kojima
Naoto Usui
Yuki Nishiyama
Nobuhito Shinozaki
Nobuyuki Shirai
Kenta Mikami
Yoichi Sato
Takahumi Noji
Izumi Noda
Yoshifumi Abe
Masakazu Saitoh
author_sort Sho Kojima
collection DOAJ
description Abstract Introduction Low physical function and depressive symptoms are frequent in older patients undergoing hemodialysis. This study aimed to investigate the association between life-space mobility (LSM), low physical function, and depressive symptoms in older patients undergoing hemodialysis. Methods This multicenter cross-sectional study included outpatients undergoing hemodialysis registered at 12 facilities in the REPnet-HD study. LSM was measured using the Life-Space Assessment. Patients were classified into four groups (normal, depressive symptoms alone, low physical function alone, and combined conditions) according to low physical function (Short Physical Performance Battery < 10 points) and depressive symptoms (Hospital Anxiety and Depression Scale > 6 points). The association among low LSM (< 60 points), physical function, and depressive symptoms was assessed using logistic regression analysis. Results Our analysis included 231 patients (aged 74 [70–78] years old; female, 40.7%; dialysis vintage, 5.5 [2.1–9.8] years). In the adjusted logistic regression analysis using reference with normal, the low LSM was significantly associated with depressive symptoms alone (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.09–5.20, P = 0.03), low physical function alone (OR 3.53, 95% CI 1.35–9.19, P = 0.009), and combined conditions (OR 10.54, 95% CI 4.16–26.75, P < 0.001). The association between low LSM and combined conditions was maintained even when the reference used low physical function alone (P = 0.04) and depressive symptoms alone (P < 0.01). Conclusions The low LSM in older patients undergoing hemodialysis was independently associated with low physical function and depressive symptoms. The combined condition of low physical function and depressive symptoms may strongly affect restricted LSM.
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spelling doaj-art-8c7c32d9e2854dc2bc34762d9ba424fd2025-08-20T03:22:57ZengBMCRenal Replacement Therapy2059-13812025-06-0111111110.1186/s41100-025-00635-6Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD studySho Kojima0Naoto Usui1Yuki Nishiyama2Nobuhito Shinozaki3Nobuyuki Shirai4Kenta Mikami5Yoichi Sato6Takahumi Noji7Izumi Noda8Yoshifumi Abe9Masakazu Saitoh10Department of Rehabilitation, Kisen HospitalDepartment of Rehabilitation, Kisen HospitalDepartment of Rehabilitation, Kisen HospitalRenal Exercise and Physical Activity Network–Virtual LaboratoryRenal Exercise and Physical Activity Network–Virtual LaboratoryRenal Exercise and Physical Activity Network–Virtual LaboratoryRenal Exercise and Physical Activity Network–Virtual LaboratoryRenal Exercise and Physical Activity Network–Virtual LaboratoryRenal Exercise and Physical Activity Network–Virtual LaboratoryRenal Exercise and Physical Activity Network–Virtual LaboratoryRenal Exercise and Physical Activity Network–Virtual LaboratoryAbstract Introduction Low physical function and depressive symptoms are frequent in older patients undergoing hemodialysis. This study aimed to investigate the association between life-space mobility (LSM), low physical function, and depressive symptoms in older patients undergoing hemodialysis. Methods This multicenter cross-sectional study included outpatients undergoing hemodialysis registered at 12 facilities in the REPnet-HD study. LSM was measured using the Life-Space Assessment. Patients were classified into four groups (normal, depressive symptoms alone, low physical function alone, and combined conditions) according to low physical function (Short Physical Performance Battery < 10 points) and depressive symptoms (Hospital Anxiety and Depression Scale > 6 points). The association among low LSM (< 60 points), physical function, and depressive symptoms was assessed using logistic regression analysis. Results Our analysis included 231 patients (aged 74 [70–78] years old; female, 40.7%; dialysis vintage, 5.5 [2.1–9.8] years). In the adjusted logistic regression analysis using reference with normal, the low LSM was significantly associated with depressive symptoms alone (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.09–5.20, P = 0.03), low physical function alone (OR 3.53, 95% CI 1.35–9.19, P = 0.009), and combined conditions (OR 10.54, 95% CI 4.16–26.75, P < 0.001). The association between low LSM and combined conditions was maintained even when the reference used low physical function alone (P = 0.04) and depressive symptoms alone (P < 0.01). Conclusions The low LSM in older patients undergoing hemodialysis was independently associated with low physical function and depressive symptoms. The combined condition of low physical function and depressive symptoms may strongly affect restricted LSM.https://doi.org/10.1186/s41100-025-00635-6HemodialysisLife-space mobilityPhysical functionDepressive symptomOlder adults
spellingShingle Sho Kojima
Naoto Usui
Yuki Nishiyama
Nobuhito Shinozaki
Nobuyuki Shirai
Kenta Mikami
Yoichi Sato
Takahumi Noji
Izumi Noda
Yoshifumi Abe
Masakazu Saitoh
Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD study
Renal Replacement Therapy
Hemodialysis
Life-space mobility
Physical function
Depressive symptom
Older adults
title Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD study
title_full Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD study
title_fullStr Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD study
title_full_unstemmed Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD study
title_short Association of life-space mobility with physical and depressive status in older hemodialysis patients: the REPnet-HD study
title_sort association of life space mobility with physical and depressive status in older hemodialysis patients the repnet hd study
topic Hemodialysis
Life-space mobility
Physical function
Depressive symptom
Older adults
url https://doi.org/10.1186/s41100-025-00635-6
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