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Nutritional Status and Adverse Outcomes in Older Depressed Inpatients: A Prospective Study

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Significant weight loss and/or loss of appetite is a criterion of a depressive episode. While malnutrition is associated with many adverse health outcomes, the impact of malnutrition in late-life depression has hardly been examined. The present study aims to (1) evaluate the prevalence of malnutrition in depressed older inpatients, and (2) whether and which indices of malnutrition predict adverse health outcomes in late-life depression.

Design

A prospective study at 6 months follow-up.

Setting

A University-based psychiatric hospital.

Participants

105 older adults (psychiatric inpatients suffering from unipolar MDD).

Measurements

Participants were evaluated according the Mini Nutritional Assessment (MNA) and anthropometric measures to assess their nutritional status. Multiple regression analyses were used to evaluate the association between the MNA score as well as anthropometric measures with either falls or rehospitalization for any reason.

Results

Based on the MNA score, 78 (74.3%) patients were at risk of malnutrition and 13 (12.4%) actually presented malnutrition. Malnutrition was associated with a higher age, frailty, lower body mass index, and smaller calf circumference. During follow-up, 21 (20%) patients fell, 27 (25.7%) were rehospitalized, and 3 died (2.9%). The MNA score was associated with adverse health outcomes, but a low calf circumference predicted falling (OR 4.93 [95% CI: 1.42–17.2], p=.012) and a higher calf circumference rehospitalization (OR 1.17 [95% CI: 1.01–1.35], p=.032).

Conclusion

Malnutrition is prevalent in older depressed inpatients. In contrast to subjective proxies for malnutrition, which are common in depression, only objective measures of malnutrition predict adverse health outcomes such as falls and rehospitalization.

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Funding

Funding: Prof. Aprahamian receives a National public grant level 2 from the National Council for Scientific and Technological Development (Ministry of Science, Technology, Innovation and Communications, Brazil).

Author information

Authors and Affiliations

  1. Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil, R. Dr. Ovídio Pires de Campos, 785, 1º andar, sala 1C 015, ZIP: 05403-903, São Paulo, Brazil

    Z. M. Lobato, A. C. Almeida da Silva, M. M. Biella, A. Santos Silva Siqueira, T. Correa de Toledo Ferraz Alves, M. K. Borges & Ivan Aprahamian

  2. School of Public Health, University of São Paulo, São Paulo, Brazil

    S. M. Lima Ribeiro

  3. Experimental Therapeutics and Molecular Pathophysiology Program, Faillace Department of Psychiatry and Behavioral Sciences, UTHealth, Houston, USA

    R. Machado-Vieira

  4. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    R. C. Oude Voshaar & Ivan Aprahamian

Authors
  1. Z. M. Lobato
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  2. A. C. Almeida da Silva
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  3. S. M. Lima Ribeiro
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  4. M. M. Biella
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  5. A. Santos Silva Siqueira
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  6. T. Correa de Toledo Ferraz Alves
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  7. R. Machado-Vieira
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  8. M. K. Borges
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  9. R. C. Oude Voshaar
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  10. Ivan Aprahamian
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Correspondence to Ivan Aprahamian.

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Lobato, Z.M., Almeida da Silva, A.C., Lima Ribeiro, S.M. et al. Nutritional Status and Adverse Outcomes in Older Depressed Inpatients: A Prospective Study. J Nutr Health Aging 25, 889–894 (2021). https://doi.org/10.1007/s12603-021-1638-y

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  • DOI: https://doi.org/10.1007/s12603-021-1638-y

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