Objective:

To delineate distinct longitudinal trajectories of Demoralization Syndrome (DS) and examine factors associated with trajectory membership in elderly ESKD patients, emphasizing the significance of understanding DS in this population.

Key Findings:

• Three DS trajectories identified: Severe Class (54.0%), Moderate Class (41.6%), and Mild Class (4.4%). Implications for clinical practice include the need for tailored interventions.
• Adverse trajectory membership associated with higher negative coping styles, lower perceived social support, lower Barthel Index scores, and more negative aging perceptions (all P < 0.05).

Interpretation:

There is considerable heterogeneity in DS trajectories among elderly ESKD patients, with most following a severe pattern, indicating a need for targeted interventions to improve patient outcomes.

Limitations:

• The study is limited to a single geographical area, which may affect generalizability.
• Potential biases in self-reported measures of coping and social support. Future research should explore these factors in diverse settings.

Conclusion:

Clinicians should monitor DS levels and consider interventions to enhance social support and coping strategies to mitigate demoralization in elderly ESKD patients, emphasizing the importance of ongoing assessment.