Depressive symptoms are associated with sarcopenia and malnutrition in older adults

Depression is one of the most common mental disorders among older adults and depressive symptoms are strongly associated with adverse health outcomes. We aim to examine whether depressive symptoms are associated with sarcopenia and malnutrition in older adults.

We reviewed hospital records of 447 patients (≥65 years) who were admitted to the outpatient clinics, retrospectively. In addition to demographic characteristics, all participants were measured for usual gait speed (UGS), handgrip strength (HGS) and skeletal muscle mass (SMMI) by using bioelectrical impedance analysis. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms. Nutritional status was screened by a mini-nutritional assessment (MNA). Cognitive function was assessed from the Mini-Mental State Examination (MMSE).

Of the 215 participants who remained after performing exclusion criteria (a clinical diagnosis of dementia (n 63), stroke (n 61), Parkinson's disease or other neurodegenerative disease (n 30), previous depression diagnosis or antidepressant medication use (n 144)), the mean age was 78 ± 8.3, the majority were female (n 133) and almost half had depressive symptoms (49.3%). Thirty-six percent had malnutrition, and 23 % had sarcopenia. The participants with depressive symptoms had lower MMSE scores (P < 0.001) and correlated with muscle mass (P < 0.001, r = -0.382), muscle strength (P < 0.001, r = -0.288), and MNA (P < 0.001, r = 0.355). Multivariate logistic regression showed that depressive symptoms were independently associated with low muscle strength (HGS: odds ratio (OR) 0.913, 95% CI: 0.866-0.962, P = 0.001), low muscle mass (SMMI: OR, 0.644, 95% CI: 0.509-0.814, P < 0.001), sarcopenia (OR, 2.536, 95% CI: 1.256-5.117, P = 0.009) and malnutrition (OR, 2.667, 95% CI: 1.467-4.850, P = 0.001).

This study demonstrated that depressive symptoms were independently associated with sarcopenia and malnutrition in older adults. Depressive disorders may lead to impaired cognitive dysfunction. Older adults at increased risk of sarcopenia and malnutrition should be screened for depression earlier.