Ivan Aprahamian, MD, MS, PhD, FACP. 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. Phone: (11) 2661-6963. São Paulo, Brazil, E-mail:
J Nutr Health Aging. 2021;25(7):889-894. doi: 10.1007/s12603-021-1638-y.
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.
A prospective study at 6 months follow-up.
A University-based psychiatric hospital.
105 older adults (psychiatric inpatients suffering from unipolar MDD).
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.
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).
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.
显著的体重减轻和/或食欲不振是抑郁发作的标准之一。虽然营养不良与许多不良健康后果有关，但在老年抑郁症中，营养不良的影响几乎没有被研究过。本研究旨在：(1)评估抑郁老年住院患者的营养不良发生率，以及 (2)营养不良是否以及哪些指标可以预测老年抑郁症的不良健康后果。
一项为期 6 个月随访的前瞻性研究。
一所大学附属医院的精神病院。
105 名老年成年人（患有单相 MDD 的住院精神科患者）。
根据 Mini Nutritional Assessment（MNA）和人体测量学测量评估参与者的营养状况。多元回归分析用于评估 MNA 评分以及人体测量指标与跌倒或因任何原因再次住院之间的关联。
根据 MNA 评分，78 名（74.3%）患者有营养不良风险，13 名（12.4%）实际上存在营养不良。营养不良与年龄较大、虚弱、较低的体重指数和较小的小腿围度有关。在随访期间，有 21 名（20%）患者跌倒，27 名（25.7%）再次住院，3 名患者死亡（2.9%）。MNA 评分与不良健康后果相关，但小腿围度较低预测跌倒（OR 4.93 [95% CI：1.42-17.2]，p=.012），小腿围度较高预测再次住院（OR 1.17 [95% CI：1.01-1.35]，p=.032）。
营养不良在老年抑郁住院患者中很常见。与抑郁症中常见的主观营养不良指标相反，只有客观的营养不良指标可以预测跌倒和再次住院等不良健康后果。
