Objective: This study aimed to assess and compare the relationships between depression, hopelessness, sleep, and quality of life in two age groups of elderly and young patients with end-stage renal disease undergoing hemodialysis (HD). Materials and Methods: The study included 130 patients under follow-up for hemodialysis (55 aged <60 years and 75 aged ≥60 years). Depression levels, sleep quality, and quality of life of all participants were evaluated using the Beck depression inventory (BDI), Beck hopelessness scale (BHS), the Pittsburgh sleep quality index, and the short form-36, respectively. Results: Of the participants, 55% (n=72) were female, and 45% (n=58) were male. The mean age was 59.48±14.57 years. There was no significant difference between the age groups concerning the BHS scores (6.82±4.73 vs. 6.57±4.20) (p=0.756). However, the BDI scores were significantly higher among younger participants (38.67±19.45 vs. 23.45±17.13) (p<0.001). Also, the sleep quality of the elderly group was significantly worse than the younger group (5.16±2.93±6.49±3.01) (p=0.013). Concerning the health-related quality of life, physical performance (45.81±19.33 vs. 39.49±13.07) and mental health (44.63±18.69 vs. 36.80±16.49) subscales were significantly lower in the elderly group (p=0.028 and p=0.013, respectively. Conclusion: We conclude that age is a significant factor requiring consideration when assessing and managing patients under HD. Although the functional capacity and sleep quality deteriorate with age, younger HD patients are more disadvantaged concerning the possibility of depression. Thus, we suggest age-specific approaches in HD patients with a multidisciplinary team.