Association Between Neuropsychiatric Symptom Burden and Chronic Kidney Disease Among Older Adults

Methods This cross-sectional study was conducted in a university hospital geriatrics outpatient clinic in Istanbul, Turkey. Participants underwent standardized neuropsychiatric assessment using the Neuropsychiatric Inventory (NPI) and a comprehensive geriatric evaluation, including activities of daily living, Mini-Nutritional Assessment, and Mini-Mental State Examination. Linear regression analyses were performed to examine associations between CKD and NPI total and domain scores. Results A total of 535 older adults were included, of whom 277 (52%) had CKD. Median NPI total score was higher in the CKD group than in those without CKD (19 vs 17, p = 0.013). In unadjusted analyses, CKD was associated with higher NPI total score and higher appetite/feeding, exaltation/euphoria, and delusion scores. After adjustment for demographic and clinical variables, CKD remained independently associated with NPI total score and appetite/feeding symptoms. Following further adjustment for laboratory and geriatric assessment parameters, the association with total NPI score was attenuated, whereas appetite/feeding symptoms remained independently associated with CKD. Appetite-related symptoms increased progressively with advancing CKD stages, while other neuropsychiatric domains showed no consistent trend. Conclusions Older adults with CKD exhibit a higher neuropsychiatric symptom burden, predominantly driven by appetite and feeding disturbances. These findings highlight the importance of systematic assessment of appetite-related symptoms in the routine clinical evaluation of older patients with CKD.