THE IMPACT OF DEPRESSION AND OTHER ASSOCIATED FACTORS ON MALNUTRITION IN THE ELDERLY IN TURKEY: A STRUCTURAL EQUATION MODELING: The Impact of Depression and Other Associated Factors on Malnutrition

Bircan ULAS KADIOĞLU; Pınar SOYLAR

Authors

Bircan ULAS KADIOĞLU Associate Professor https://orcid.org/0000-0002-1150-8761
Pınar SOYLAR Associate Professor https://orcid.org/0000-0003-1565-2100

Keywords:

Malnutrition, nutrition, depression, elderly people

Abstract

The aim of this research is to evaluate the nutritional status, depression status and some related factors of elderly people. The sampling of the descriptive and cross-sectional research consists of 365 elderly people. The data of the research were collected through the Personal Information Form, Mini Nutritional Assessment Test (MNA), and Geriatric Depression Scale (GDS). Malnutrition was found in 4.1% and malnutrition risk was detected in 26.6%. It was determined that 41.9% had depression. Path analyzes were conducted using AMOS v24 to investigate the relationships between MNA and GDS, gender, age, income level, presence of chronic disease, and whether or not living alone. A model was established to reveal the relationships between income, age, gender, presence of chronic disease, and living alone with MNA and GDS. In line with the insignificant path coefficients in both men and women, these paths were removed from the model and the new model was analyzed again. After removing the insignificant path coefficients from the model, in women; the path coefficient between GDS and income was found to be statistically significant, and as the income level increases, GDS increases. It was found that depression decreased in men not living alone. Malnutrition in men and women is associated with age and depression. The significant path coefficients retained in the model provide compelling evidence of complex relationships between sociodemographic factors, nutritional status, and depression. A holistic approach should be adopted in managing the health of the elderly people.

Author Biographies

Bircan ULAS KADIOĞLU, Associate Professor

Osmaniye Korkut Ata University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Osmaniye, Turkey

Pınar SOYLAR, Associate Professor

Nursing Department, Health Science Faculty, Firat University, Elazig, Turkey

References

Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, Compher C, Correia I, Higashiguchi T, Holst M, Jensen GL, Malone A, Muscaritoli M, Nyulasi I, Pirlich M, Rothenberg E, Schindler K, Schneider SM, de van der Schueren MA, Sieber C, Valentini L, Yu JC, Van Gossum A, Singer P. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017; 36(1):49-64.

Abd Aziz NAS, Mohd Fahmi Teng NI, Kamarul Zaman M. Geriatric Nutrition Risk Index is comparable to the mini nutritional assessment for assessing nutritional status in elderly hospitalized patients. Clin Nutr ESPEN. 2019; 29:77-85.

Aksoydan E. Yaşlılık ve Beslenme. Ankara, Şubat, 2008. https://sbu.saglik.gov.tr/Ekutuphane/kitaplar/A%201.pdf

Misu S, Asai T, Doi T, Sawa R, Ueda Y, Saito T, Nakamura R, Murata S, Sugimoto T, Yamada M, Ono R: Association between gait abnormality and malnutrition in a community-dwelling elderly population. Geriatr Gerontol Int 2017; 17:1155-1160.

Hastaoğlu F, Hastaoğlu E. Current problems of the elderly: Poor Nutrition. Journal of Current Researches on Health Sector. 2018; 8(1):89-94.

Saka B, Özkulluk H. Evaluation of the nutritional status and relationship of malnutrition with other geriatric syndromes in elderly patients who admitted to the internal medicine outpatient clinic. Gülhane Tıp Dergisi, 2008;50(3):151-7.

Paun O. Older Adults and Late-Life Depression. J Psychosoc Nurs Ment Health Serv. 2023;61(4):8-9.

Hidese S, Asano S, Saito K, Sasayama D, Kunugi H. Association of depres¬sion with body mass index classification, metabolic disease, and lifestyle: a web-based survey involving 11,876 Japanese people. J Psychiatr Res. 2018; 102:23–8.

Çiğiloğlu A, Efendioğlu E M, Öztürk Z A. Factors Associated with Nutritional Status n Geriatric Outpatients. Nam Kem Med J 2022;10(3):276-282

Tan J, Ma C, Zhu C, Wang Y, Zou X, Li H, Li J, He Y, Wu C. Prediction models for depression risk among older adults: systematic review and critical appraisal. Ageing Res Rev. 2023; 83:101803.

Balcı E, Şenol V, Eşel E, Günay O, Elmalı F. The Relationship between Malnutrition and Depression in People Aged Over 65 Years. Turkish Journal of Public Health. 2012; 10(1):37-43.

Cascio B L, Logomarsino J V. Evaluating the effectiveness of five screening tools used to identify malnutrition risk in hospitalized elderly: A systematic review, Geriatric Nursing 2018; 39 (1): 95–102.

Park S H, Kwak M J. Performance of the Geriatric Depression Scale-15 with Older Adults Aged over 65 Years: An Updated Review 2000-2019. Clinical Gerontologist, 2021; 44(2):83–96.

Burke CA, McKiernan M. RN Residents improving geriatric depression screening at Phelps hospital. Geriatric Nursing. 2022; 48: 360-363.

Gündüz E, Eskin F, Gündüz M, Bentli R, Zengin Y, Dursun R, İçer M, Durgun HM, Gürbüz H, Ekinci M, Yeşil Y, Güloğlu C. Malnutrition in Community-Dwelling Elderly in Turkey: A Multicenter, Cross-Sectional Study. Med Sci Monit. 2015; 21: 2750-2756.

Sarıkaya, D. Geriatrik hastalarda Mini Nütrisyonel Değerlendirme (MNA) testinin uzun ve kısa (MNA-SF) formunun geçerlilik çalışması. Uzmanlık tezi. Hacettepe Üniversitesi, Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, 2013.

Cereda E. Mini nutritional assessment. Curr Opin Clin Nutr Metab Care. 2012;15(1):29-41.

Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale. A preliminary report. J Psychiatr Res.1983;17: 37-49.

Burke WJ, Roccaforte WH, Wengel SP. The short form of the geriatric depression scale: A comparision with the 30-item form. J Geriatr Psychiatry Neurol.1991;4: 173-8.

Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: Are there different factor structures for different cultures? Int Psychogeriatr. 2000; 12: 163-72.

Durmaz B, Soysal P, Ellidokuz H, Isik AT. Validity and reliability of geriatric depression scale-15 (short form) in Turkish older adults. North Clin Istanb 2018;5(3):216–220.

Naidoo, I., Charlton, K.E., Esterhuizen, T. et al. High risk of malnutrition associated with depressive symptoms in older South Africans living in KwaZulu-Natal, South Africa: a cross-sectional survey. Journal of Health, Population and Nutrition. 2015; 33:1-8.

Erdoğan T, Tunca H. The multiple functional and nutritional status assessment of geriatric outpatient in the internal medicine department. Osmangazi Journal of Medicine. 2016;38(3): 17-24.

H E. Combining drugs improved hard-to-treat Depression in older adults. JAMA. 2023;329(13):1053.

Chavarro-Carvajal D, Reyes-Ortiz C, Samper-Ternent R, Arciniegas AJ, Gutierrez CC. Nutritional assessment and factors associated to malnutrition in older adults: a cross-sectional study in Bogotá, Colombia. J Aging Health. 2015;27(2):304-319.

O’Loughlin J, Casanova F, Fairhurst-Hunter Z, Hughes A, Bowden J, Watkins ER, Freathy RM, Millwood IY, Lin K, Chen Z, et al. Mendelian randomization study of body composition and depression in people of east Asian ancestry highlights potential setting-specific causality. BMC Med. 2023;21(1):37.

Kong W, Jiang T, Ning Y, Guo Y, Liu H, Xiongxiong LY U, Li M. Dietary diversity, diet quality, and oxidative stress in older adults. Geriatric Nursing. 2022; 48:158-163.

Smith L, Ng R, Lopez-Sanchez G F. The Association Between Objective and Subjective Socioeconomic Status and Subjective Well-Being: A Meta-Analysis. Social Indicators Research, 2016; 128(2): 725-745.

Jones S M, Walker R, Fujii D, Nekhlyudov L, Locke A. (2017). Financial Stress and Outcomes after Acute Myocardial Infarction. PLoS ONE, 12(10): e0187011.

Parker MG, Thorslund M. Health Trends in the Elderly Population: Getting Better and Getting Worse. Gerontologist. 2007; 47(2): 150-158.

Hansen T, Slagsvold B, Solem P E. Gender, Lifespan Changes, and Psychological Well-Being: A Cross-Sectional Study of Older Couples. Aging & Mental Health, 2018; 22(7): 976-985.

Khan A, Plummer M, Hussain R, Minichiello V. Social Support and Health Among Older People in South Asia: A Systematic Review. BioMed Research International, 2019, Article ID 6789823.

Lopez B R, Lincoln A J, Ozonoff S, Lai Z. Examining the Relationship Between Executive Functions and Restricted, Repetitive Symptoms of Autistic Disorder. Journal of Autism and Developmental Disorders, 2020;40(9): 1108-1118.

THE IMPACT OF DEPRESSION AND OTHER ASSOCIATED FACTORS ON MALNUTRITION IN THE ELDERLY IN TURKEY: A STRUCTURAL EQUATION MODELING