Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma RM, Italy; Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Ave, Los Angeles, CA 90089, USA.
Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Roma RM, Italy.
Arch Gerontol Geriatr. 2020 May-Jun;88:104022. doi: 10.1016/j.archger.2020.104022. Epub 2020 Feb 13.
Adherence to Mediterranean Diet (Med-Diet) has been associated with a lower incidence of chronic diseases and may be associated with lower risk for depression. The aim of the present study was to investigate (i) the association of adherence to Med-Diet with depressive symptoms and multimorbidity in a cohort of geriatric medical outpatients, and (ii) the role of Med-Diet in mediating the association between depressive symptoms and multimorbidity.
A total of 143 geriatric patients (mean age: 73.1 ± 8.35) were included. Adherence to Med-Diet was evaluated using a validated 14-item questionnaire; depressive and cognitive symptoms were assessed through the 15-item Geriatric Depression Scale (GDS) and Mini Mental State Examination (MMSE) respectively; multimorbidity was evaluated using the Cumulative Illness Rating Scale for Geriatrics (CIRSG-SI).
Significant associations were found between MDQ score, GDS and CIRSG-SI (MDQ score and GDS: r= -0.206, p = 0.014; MDQ score and CIRSG-SI: r= -0.247, p = 0.003; GDS and CIRSG-SI: r = 0.251; p = 0.003). These associations remained significant after adjusting for potential confounding factors. A mediational model analysis showed that the direct effect of CIRSG-SI on GDS was significant (b = 1.330; se = 0.59; p = 0.028) with this effect being counterbalanced by higher MDQ scores (indirect effect of CIRS-G on GDS through MDQ: b = 0.382; se = 0.19; p = 0.048).
These findings (i) add to the accumulating evidence that Med-Diet may have a positive impact on mental health in the elderly, and (ii) suggest that Med-Diet may contribute, at least in part, to protect geriatric patients with multimorbidity from the development of depressive symptoms, ultimately promoting healthy aging.
地中海饮食（Med-Diet）的依从性与慢性疾病的发病率较低有关，并且可能与抑郁风险降低有关。本研究的目的是调查（i）在老年医学门诊患者队列中，Med-Diet 的依从性与抑郁症状和多种合并症之间的关系，以及（ii）Med-Diet 在介导抑郁症状和多种合并症之间的关系中的作用。
共纳入 143 名老年患者（平均年龄：73.1±8.35 岁）。使用经过验证的 14 项问卷评估 Med-Diet 的依从性；通过 15 项老年抑郁量表（GDS）和简易精神状态检查（MMSE）分别评估抑郁和认知症状；使用老年人累积疾病评分量表（CIRSG-SI）评估多种合并症。
MDQ 评分、GDS 和 CIRSG-SI 之间存在显著相关性（MDQ 评分和 GDS：r=-0.206，p=0.014；MDQ 评分和 CIRSG-SI：r=-0.247，p=0.003；GDS 和 CIRSG-SI：r=0.251，p=0.003）。在调整潜在混杂因素后，这些相关性仍然显著。中介模型分析表明，CIRSG-SI 对 GDS 的直接影响具有统计学意义（b=1.330；se=0.59；p=0.028），而 MDQ 评分较高则抵消了这种影响（CIRS-G 通过 MDQ 对 GDS 的间接影响：b=0.382；se=0.19；p=0.048）。
这些发现（i）增加了越来越多的证据表明 Med-Diet 可能对老年人的心理健康产生积极影响，（ii）表明 Med-Diet 可能至少部分有助于保护患有多种合并症的老年患者免受抑郁症状的发展，最终促进健康老龄化。
